Provider Demographics
NPI:1427325026
Name:ANGUSTIA, CUMANDA DELROCIO (FNP)
Entity type:Individual
Prefix:MRS
First Name:CUMANDA
Middle Name:DELROCIO
Last Name:ANGUSTIA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Mailing Address - Street 1:10 STOCKHOLM ST
Mailing Address - Street 2:2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11221-3110
Mailing Address - Country:US
Mailing Address - Phone:718-644-6944
Mailing Address - Fax:
Practice Address - Street 1:385 SENECA AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-1340
Practice Address - Country:US
Practice Address - Phone:718-821-1222
Practice Address - Fax:718-418-7490
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-27
Last Update Date:2013-05-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY337028363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03437996Medicaid