Provider Demographics
NPI:1609141951
Name:AGILITY MEDICAL CARE, P.C.
Entity Type:Organization
Organization Name:AGILITY MEDICAL CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AREFIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDDIQUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-896-1300
Mailing Address - Street 1:1983 ROUTE 52
Mailing Address - Street 2:SUITE 4
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-3513
Mailing Address - Country:US
Mailing Address - Phone:845-896-1300
Mailing Address - Fax:845-896-2600
Practice Address - Street 1:1983 ROUTE 52
Practice Address - Street 2:SUITE 4
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-3513
Practice Address - Country:US
Practice Address - Phone:845-896-1300
Practice Address - Fax:845-896-2600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY221473208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty