MEDICARE: CLAUDE S DESAUGUSTE PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1134059710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDE S DESAUGUSTE PA

Provider Business Mailing Address
First Line	:	543 PERRY DR
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-5804
Country	:	US
Telephone Number	:	732-799-1943
Fax Number	:

Provider Business Practice Location Address
First Line	:	543 PERRY DR
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-5804
Country	:	US
Telephone Number	:	732-799-1943
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2026
Last Update Date	:	05/23/2026

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