Healthcare Provider Details

I. General information

NPI: 1750430815
Provider Name (Legal Business Name): ANN MARIE AUGUSTYN M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 LITTLE ALBANY ST ROOM 1138
NEW BRUNSWICK NJ
08901-1914
US

IV. Provider business mailing address

92 MONROE PL # 15
BLOOMFIELD NJ
07003-3545
US

V. Phone/Fax

Practice location:
  • Phone: 732-235-9652
  • Fax:
Mailing address:
  • Phone: 973-429-3238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: