Healthcare Provider Details

I. General information

NPI: 1467375782
Provider Name (Legal Business Name): AUGUSTINE YEBOAH RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 US HIGHWAY 1 S
EDISON NJ
08837-3113
US

IV. Provider business mailing address

1245 US HIGHWAY 1 S
EDISON NJ
08837-3113
US

V. Phone/Fax

Practice location:
  • Phone: 908-267-4143
  • Fax:
Mailing address:
  • Phone: 908-267-4143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number43ZA00697700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: