Agave Medical NJ PC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

AGAVE MEDICAL NJ PC

Practice address

359 5TH St Unit 3
Jersey City, NJ 07302-2329

Phone

(929) 209-6109

NPI assigned

Jul 24, 2025

Organization subpart

No

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

Authorized official

Name

Ori Fruhauf

Title

Owner

Phone

(551) 302-1794

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1753315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753315200000",
    "number": "1619859238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "359 5TH ST UNIT 3",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073022329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359 5TH ST UNIT 3",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073022329",
            "telephone_number": "929-209-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAVE MEDICAL NJ PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-24",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-23",
        "status": "A",
        "authorized_official_last_name": "FRUHAUF",
        "authorized_official_first_name": "ORI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "551-302-1794"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.