Provider Demographics
NPI:1598442683
Name:HONRADO, AUGUSTO
Entity Type:Individual
Prefix:
First Name:AUGUSTO
Middle Name:
Last Name:HONRADO
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 1:330 MILLTOWN RD STE E22
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-2287
Mailing Address - Country:US
Mailing Address - Phone:848-205-1799
Mailing Address - Fax:
Practice Address - Street 1:330 MILLTOWN RD STE E22
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-2287
Practice Address - Country:US
Practice Address - Phone:848-205-1799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118148104100000X
NJ44SL06810900104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker