Provider Demographics
NPI:1376201491
Name:NYRIE AUSTIN NURSE PRACTITIONER IN FAMILY HEALTH P.C.
Entity Type:Organization
Organization Name:NYRIE AUSTIN NURSE PRACTITIONER IN FAMILY HEALTH P.C.
Other - Org Name:DERMA HEAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:NYRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:551-502-8360
Mailing Address - Street 1:3-18 CYRIL AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-2021
Mailing Address - Country:US
Mailing Address - Phone:516-427-0374
Mailing Address - Fax:
Practice Address - Street 1:3 CHURCH ST STE 858
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-6301
Practice Address - Country:US
Practice Address - Phone:516-427-0374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-06
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty