Individual
KRISTY DEAUGUSTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 PARK AVE, NEW YORK, NY 10016-5802
(212) 263-7419
Mailing address
1 PARK AVE, NEW YORK, NY 10016-5802
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402967
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
SP016708
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
402967
CRNP LICENSE
NY
Enumeration date
08/24/2016
Last updated
10/17/2024
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