Individual
JOHN AUGUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
850 S 11TH ST, NEWARK, NJ 07108-1304
(973) 373-6066
Mailing address
850 S 11TH ST, NEWARK, NJ 07108-1304
(973) 373-6066
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA024356
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2764806
—
NJ
Enumeration date
08/26/2006
Last updated
07/08/2007
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