Provider Demographics
NPI:1093805384
Name:JEFFREY F. AUGUSTIN, M.D. P.A.
Entity Type:Organization
Organization Name:JEFFREY F. AUGUSTIN, M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:F
Authorized Official - Last Name:AUGUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-373-5353
Mailing Address - Street 1:526 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-3734
Mailing Address - Country:US
Mailing Address - Phone:973-373-5353
Mailing Address - Fax:973-373-5353
Practice Address - Street 1:526 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3734
Practice Address - Country:US
Practice Address - Phone:201-437-9700
Practice Address - Fax:201-437-9705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-15
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ106243Medicare PIN
NJ6522940001Medicare NSC