Healthcare Provider Details

I. General information

NPI: 1952786980
Provider Name (Legal Business Name): CINDY AUGUSTE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2015
Last Update Date: 12/09/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 VAN WYCK EXPY
RICHMOND HILL NY
11418-2832
US

IV. Provider business mailing address

555 E 79TH ST
BROOKLYN NY
11236-3134
US

V. Phone/Fax

Practice location:
  • Phone: 718-206-7207
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF403797-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number701498-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: