Provider Demographics
NPI:1700085024
Name:ARYEE, AUGUSTUS (CRNA)
Entity Type:Individual
Prefix:MR
First Name:AUGUSTUS
Middle Name:
Last Name:ARYEE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:140 VAN CORTLANDT AVE W
Mailing Address - Street 2:APT 4D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-2705
Mailing Address - Country:US
Mailing Address - Phone:347-275-5723
Mailing Address - Fax:347-275-5723
Practice Address - Street 1:5115 BEACH CHANNEL DR
Practice Address - Street 2:FAR ROCKAWAY
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-1042
Practice Address - Country:US
Practice Address - Phone:718-734-3110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073406367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered