Provider Demographics
NPI:1801209382
Name:THE AUGURY FOR WOMEN'S HEALTH MEDICAL PLLC
Entity Type:Organization
Organization Name:THE AUGURY FOR WOMEN'S HEALTH MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EAV
Authorized Official - Middle Name:KUONG
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:917-915-0115
Mailing Address - Street 1:6852 FRESH POND RD
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-5230
Mailing Address - Country:US
Mailing Address - Phone:718-497-3045
Mailing Address - Fax:718-497-3126
Practice Address - Street 1:6852 FRESH POND RD
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-5230
Practice Address - Country:US
Practice Address - Phone:718-497-3045
Practice Address - Fax:718-497-3126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-03
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY105468207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty