Provider Demographics
NPI:1003076605
Name:TILNEY, AUGUSTA (MD)
Entity Type:Individual
Prefix:DR
First Name:AUGUSTA
Middle Name:
Last Name:TILNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 W 81ST ST
Mailing Address - Street 2:SUITE 1-C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6023
Mailing Address - Country:US
Mailing Address - Phone:212-874-4339
Mailing Address - Fax:212-769-3046
Practice Address - Street 1:25 W 81ST ST
Practice Address - Street 2:SUITE 1-C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6023
Practice Address - Country:US
Practice Address - Phone:212-874-4339
Practice Address - Fax:212-769-3046
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199167102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst