Agustin, Erie T

Agustin, Erie T is an individual health care provider with primary practice located at 5718 Woodside Ave Fl 2 , Woodside NY 11377-3415. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Agustin, Erie T can be contacted via phone (718) 205-0030.

Contact Information

Primary practice address
5718 Woodside Ave Fl 2 Woodside NY 11377-3415
Phone: (718) 205-0030
Fax: (718) 205-6136
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 196473 New York
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 196473 New York

Profile Details

NPI number 1407892144
LBN Legal business name Agustin, Erie T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2006
Last updated Nov 21st, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407892144 NPPES
New York MEDICAID 01551775

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