Individual
ERIE T AGUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5718 WOODSIDE AVE FL 2, WOODSIDE, NY 11377-3415
(718) 205-0030
(718) 205-6136
Mailing address
5718 WOODSIDE AVE FL 2, WOODSIDE, NY 11377-3415
(718) 205-0030
(718) 205-6136
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
196473
NY
207Q00000X
Family Medicine Physician
Primary
196473
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01551775
—
NY
Enumeration date
06/21/2006
Last updated
11/21/2012
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