Provider Demographics
NPI:1508640319
Name:AGORDO, ESTHER E
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:E
Last Name:AGORDO
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 1:480 E 188TH ST APT 12H
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-5841
Mailing Address - Country:US
Mailing Address - Phone:929-374-8009
Mailing Address - Fax:
Practice Address - Street 1:3250 WESTCHESTER AVE STE 202
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-4580
Practice Address - Country:US
Practice Address - Phone:917-407-2297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY2758115390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program