Provider Demographics
NPI:1316579212
Name:AUGUSTE, FABIEN D
Entity Type:Individual
Prefix:
First Name:FABIEN
Middle Name:D
Last Name:AUGUSTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 OLD YORK RD STE 703B
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-3735
Mailing Address - Country:US
Mailing Address - Phone:484-425-9492
Mailing Address - Fax:
Practice Address - Street 1:261 OLD YORK RD STE 703B
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3735
Practice Address - Country:US
Practice Address - Phone:484-425-9492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider