Active NPI
Woodhull Medical Group
- Physician Assistant
- Brooklyn, NY
National Provider Identifier
1053474395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 009897
- Legal business name
- WOODHULL MEDICAL GROUP
- Practice address
- 760 Broadway
Brooklyn, NY 11206-5317 - Phone
- (718) 963-5735
- Fax
- (718) 630-3045
- NPI assigned
- Dec 18, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Riticia Christine Augusty, P.A.
- Title
- Physician Assistant
- Phone
- (718) 983-7808
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 009897 | NY | Primary |
Addresses
Primary practice location
760 Broadway
Brooklyn, NY 11206-5317
Mailing address
403 Woolley Ave
Staten Island, NY 10314-2142
Phone (718) 983-7808
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1053474395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "403 WOOLLEY AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103142142",
"telephone_number": "718-983-7808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "760 BROADWAY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112065317",
"telephone_number": "718-963-5735",
"fax_number": "718-630-3045"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WOODHULL MEDICAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-18",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "AUGUSTY",
"authorized_official_first_name": "RITICIA",
"authorized_official_middle_name": "CHRISTINE",
"authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
"authorized_official_telephone_number": "17189837808",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "P.A."
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": "NY",
"license": "009897",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.