Provider Demographics
NPI:1215288485
Name:AGAMI, OREL
Entity type:Individual
Prefix:
First Name:OREL
Middle Name:
Last Name:AGAMI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 ROSEDALE RD APT 1
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-2802
Mailing Address - Country:US
Mailing Address - Phone:585-957-5946
Mailing Address - Fax:
Practice Address - Street 1:520 E 70TH ST
Practice Address - Street 2:STARR 341
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-9800
Practice Address - Country:US
Practice Address - Phone:646-962-2068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-27
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical