Provider Demographics
NPI:1992227763
Name:AGYEI, CYNTHIA OPUNI
Entity type:Individual
Prefix:MISS
First Name:CYNTHIA
Middle Name:OPUNI
Last Name:AGYEI
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 1:2 MCCLELLAN TER
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-4516
Mailing Address - Country:US
Mailing Address - Phone:646-724-2883
Mailing Address - Fax:
Practice Address - Street 1:737 NORTHFIELD AVE
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1103
Practice Address - Country:US
Practice Address - Phone:973-544-8901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF308213363LA2200X
NJ26NJ00886300363LG0600X, 363LA2200X
NYF308213-1363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology