Individual
VICKYANA AUGUSTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10 2ND AVE, HASKELL, NJ 07420-1109
(917) 683-4658
Mailing address
101 CONKLINTOWN RD, WANAQUE, NJ 07465-1605
(862) 253-6355
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
26NP07836400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26NP07836400
—
NJ
Enumeration date
03/26/2021
Last updated
03/26/2021
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