Provider Demographics
NPI:1144183153
Name:AGAPE LIFE HEALTH NP IN PSYCHIATRY AND FAMILY HEALTH PLLC
Entity type:Organization
Organization Name:AGAPE LIFE HEALTH NP IN PSYCHIATRY AND FAMILY HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AHIPUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-607-1516
Mailing Address - Street 1:962 KATHLEEN CIR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-6469
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3534 AMBOY RD APT B2
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-2700
Practice Address - Country:US
Practice Address - Phone:718-607-1516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-05
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty