Provider Demographics
NPI:1184984452
Name:AUGUSTE, JUANULETE S (LPN)
Entity type:Individual
Prefix:
First Name:JUANULETE
Middle Name:S
Last Name:AUGUSTE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 VANDALIA AVE
Mailing Address - Street 2:APT. 17E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11239-1015
Mailing Address - Country:US
Mailing Address - Phone:347-645-7634
Mailing Address - Fax:
Practice Address - Street 1:20 VANDALIA AVE
Practice Address - Street 2:APT. 17E
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11239-1015
Practice Address - Country:US
Practice Address - Phone:347-645-7634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309505164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse