Individual
ANDRE AUGUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
135 BLOOMFIELD AVE STE F, BLOOMFIELD, NJ 07003-5902
(862) 213-0033
(862) 213-0037
Mailing address
55 A LINN DR, VERONA, NJ 07044
(973) 641-0353
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
26NJ01282100
NJ
363LG0600X
Gerontology Nurse Practitioner
Primary
26NJ01282100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26NJ01282100
NP
NJ
Enumeration date
03/11/2022
Last updated
04/07/2022
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