Provider Demographics
NPI:1235207838
Name:AGUSTIN, ELMER C (MD)
Entity Type:Individual
Prefix:DR
First Name:ELMER
Middle Name:C
Last Name:AGUSTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:24 EDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5943
Mailing Address - Country:US
Mailing Address - Phone:914-472-5920
Mailing Address - Fax:212-423-8121
Practice Address - Street 1:1901 1ST AVE
Practice Address - Street 2:DEPARTMENT OF OBSTETRICS & GYNECOLOGY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-7404
Practice Address - Country:US
Practice Address - Phone:212-423-6796
Practice Address - Fax:212-423-8121
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173065207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology