NPIMap

Organization Active NPI

Erie T Agustin MD PC

  • Clinic/Center
  • Woodside, NY
National Provider Identifier
1306037247
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ERIE T AGUSTIN MD PC
Doing business as
Erie T Agustin MD PC
Practice address
5801 Woodside Ave Ste 2
Woodside, NY 11377-3437
Phone
(718) 205-0030
Fax
(806) 552-9573
NPI assigned
Aug 6, 2007
Last updated
Sep 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Erie T. Agustin, MDNPI 1407892144
Title
President
Phone
(718) 205-0030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

5801 Woodside Ave Ste 2
Woodside, NY 11377-3437

Mailing address

5801 Woodside Ave Ste 2
Woodside, NY 11377-3437
Phone (718) 205-0030

Other names 1

  • Erie T Agustin MD PC Doing business as

National Provider Directory

National Provider Directory

Locations

5407 Roosevelt Ave
Woodside, NY 11377
Phone (718) 205-0030

5718 Woodside Ave
Ste 1
Woodside, NY 11377
Phone (718) 205-0030

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695340800000",
    "number": "1306037247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 WOODSIDE AVE STE 2",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773437",
            "telephone_number": "718-205-0030",
            "fax_number": "718-205-6136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 WOODSIDE AVE STE 2",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773437",
            "telephone_number": "718-205-0030",
            "fax_number": "806-552-9573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIE T AGUSTIN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A",
        "authorized_official_last_name": "AGUSTIN",
        "authorized_official_first_name": "ERIE",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-205-0030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Erie T Agustin MD PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Erie T Agustin MD PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.