Most Relevant Information
Provider Data
| NPI Number: | 1003503806 |
| Provider Name: | AUGUSTUS CARRUCCIU PARKER |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/20/2023 |
| Last Updated: | 04/20/2023 |
Provider Practice Location
550 1ST AVE
NEW YORK
NY
100166402
Practice Location Phone/Fax
| Phone: | 2122635506 |
| Fax: |
Provider Mailing Location
334 E 26TH ST APT 22H2
NEW YORK
NY
100101915
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |