Individual provider · Type 1 NPI

Anna G. Custodio, AGPCNP-BC

Primary Care Nurse Practitioner · New York, NY

NPI number 1275149106 Active

Practice location

480 Main St Apt 3G
New York, NY 10044-0406

Call (845) 521-2887 Map

Other practice locations

  • 535 East 73rd St, New York, NY 10044 · (646) 608-3824

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000X604515 (NY)
Primary Care Nurse Practitioner Primary 363LP2300XF309861-01 (NY)

Primary Care Nurse Practitioner: Definition to come...

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About NPI 1275149106

Anna G. Custodio, AGPCNP-BC's National Provider Identifier is 1275149106, issued on Sep 16, 2020. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in New York, NY. The record was last updated on Sep 16, 2020.