NPIMap

Organization Active NPI

Ageless Men's Health

  • Clinic/Center
  • New York, NY
National Provider Identifier
1760749634
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
22 634573 Issued in NY
Legal business name
AGELESS MEN'S HEALTH
Practice address
65 Broadway Ste 1804
New York, NY 10006-2560
Phone
(212) 430-6677
Fax
(212) 430-6678
NPI assigned
Apr 17, 2012
Last updated
Nov 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Authorized official

Name
Amanda Wilkinson
Title
Business Operations Director
Phone
(702) 818-0446

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 22 634573 NY Primary

Addresses

Primary practice location

65 Broadway Ste 1804
New York, NY 10006-2560

Mailing address

65 Broadway Ste 1804
New York, NY 10006-2560

National Provider Directory

National Provider Directory
Tax ID family
Ageless Men's Health9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

65 Broadway
Ste 1804
New York, NY 10006
Phone (212) 430-6677

Practitioners & affiliated clinicians

Practitioners 2

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": "1334620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732233600000",
    "number": "1760749634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 BROADWAY STE 1804",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100062560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 BROADWAY STE 1804",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100062560",
            "telephone_number": "212-430-6677",
            "fax_number": "212-430-6678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGELESS MEN'S HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-17",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A",
        "authorized_official_last_name": "WILKINSON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "BUSINESS OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "702-818-0446"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "22 634573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.