Individual
JOHAN AGUDELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
5030 BROADWAY, NEW YORK, NY 10034-1609
(844) 663-2255
Mailing address
5030 BROADWAY, NEW YORK, NY 10034-1609
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
408048
NY
Other
Enumeration date
03/20/2026
Last updated
03/20/2026
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