Organization Active NPI

Linda Agyeiwaa LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Englewood, NJ
National Provider Identifier
1366239543
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
LINDA AGYEIWAA LLC
Practice address
170 Lincoln St
Englewood, NJ 07631-3118
Phone
(201) 500-6992
Fax
(833) 605-4359
NPI assigned
Apr 22, 2025
Last updated
May 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Authorized official

Name
Eilis Pasko
Title
Credentialing Associate
Phone
(201) 500-6992

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X Primary

Addresses

Primary practice location

170 Lincoln St
Englewood, NJ 07631-3118

Mailing address

28 Millbrook Dr
Willingboro, NJ 08046-3130
Phone (732) 306-0109

Other identifiers 1

IdentifierTypeStateIssuer
1004883MedicaidNJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1745280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746576000000",
    "number": "1366239543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 MILLBROOK DR",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080463130",
            "telephone_number": "732-306-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 LINCOLN ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076313118",
            "telephone_number": "201-500-6992",
            "fax_number": "833-605-4359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDA AGYEIWAA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-22",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A",
        "authorized_official_last_name": "PASKO",
        "authorized_official_first_name": "EILIS",
        "authorized_official_title_or_position": "CREDENTIALING ASSOCIATE",
        "authorized_official_telephone_number": "201-500-6992"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1004883",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.