Provider Demographics
NPI:1730322645
Name:AGI MEDICAL PLLC
Entity Type:Organization
Organization Name:AGI MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:PEIYING
Authorized Official - Middle Name:
Authorized Official - Last Name:XIAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-701-1278
Mailing Address - Street 1:232 BAY 7TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3807
Mailing Address - Country:US
Mailing Address - Phone:646-701-1278
Mailing Address - Fax:718-513-3303
Practice Address - Street 1:717 56TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3503
Practice Address - Country:US
Practice Address - Phone:718-435-3890
Practice Address - Fax:718-435-3489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-08
Last Update Date:2013-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY240108174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02985371Medicaid
NY02985371Medicaid