Agape Family Medical Center LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

AGAPE FAMILY MEDICAL CENTER LLC

Practice address

1078 W Main St Ste 3
Waterbury, CT 06708-2651

Phone

(860) 797-0572

NPI assigned

Aug 21, 2020

Last updated

Aug 21, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Felistas Mazhandu, APRNNPI 1144674672

Title

Owner

Phone

(860) 797-0572

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Felistas Mazhandu, APRN

  • Family Nurse Practitioner
  • Meriden, CT
  • NPI 1144674672
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597968000000",
    "number": "1316559248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WOODLAND TRL",
            "city": "ELLINGTON",
            "state": "CT",
            "postal_code": "060293890",
            "telephone_number": "860-797-0572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1078 W MAIN ST STE 3",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082651",
            "telephone_number": "860-797-0572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE FAMILY MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-21",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A",
        "authorized_official_last_name": "MAZHANDU",
        "authorized_official_first_name": "FELISTAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-797-0572",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Advanced Allergy and Asthma Family Care,LLC
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• Advanced Solutions Therapy Center LLC
• Barbara Fosua Afful
• Melanie Aftowski
• Agape Family Medical Clinic Inc
• Radhika Abhishek Agrawal, M.D.
• Syed Ahamed, RPH
• Wessam Naser Ahmed
• Hannah Ahrens

• Family Nurse Practitioner in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.