Organization
AGAVE MEDICAL NJ PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ORI FRUHAUF (OWNER)
(551) 302-1794
Entity
Organization
Contact information
Practice address
359 5TH ST UNIT 3, JERSEY CITY, NJ 07302-2329
(929) 209-6109
Mailing address
359 5TH ST UNIT 3, JERSEY CITY, NJ 07302-2329
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
07/24/2025
Last updated
07/24/2025
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