Provider Demographics
NPI:1437653755
Name:AGBAYANI, NESTOR A JR (M)
Entity Type:Individual
Prefix:DR
First Name:NESTOR
Middle Name:A
Last Name:AGBAYANI
Suffix:JR
Gender:M
Credentials:M
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 PELHAM PKWY S
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1138
Mailing Address - Country:US
Mailing Address - Phone:718-918-5820
Mailing Address - Fax:
Practice Address - Street 1:1400 PELHAM PKWY S BLDG 6
Practice Address - Street 2:SUITE B125
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1138
Practice Address - Country:US
Practice Address - Phone:718-918-5820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program