Individual
MR. EDWIN S EUSTAQUIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
888 FOUNTAIN AVENUE, BROOKLYN, NY 11208
(718) 642-6063
(718) 642-3857
Mailing address
41 MEADOWWOOD LANE, FARMINGDALE, NY 11735
(516) 756-1689
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0046351
NY
363AS0400X
Surgical Physician Assistant
0046351
NY
Other
Enumeration date
04/16/2007
Last updated
04/19/2026
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