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Anna Custodio, AGPCNP-BC — NPI 1275149106, New York, NY | NPI Central

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NPI 1275149106

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Anna Custodio, AGPCNP-BC

NPI 1275149106 · Primary Care Nurse Practitioner · New York, NY

Provider details

NPI number: 1275149106
Entity type: Individual
Primary specialty: Primary Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Credential: AGPCNP-BC
Sex: Female
Sole proprietor: No
License: 604515 (NY)

Specialties & taxonomies

Primary Care Nurse PractitionerPrimary363LP2300XLicense F309861-01 (NY)
Physician Assistants & Advanced Practice Nursing Providers
Registered Nurse163W00000XLicense 604515 (NY)
Nursing Service Providers

Practice location

480 Main St Apt 3g

New York, NY 10044-0406

Phone: (845) 521-2887

Approximate (ZIP-level) locationGet directions

More NY providers

Mailing address

480 Main St Apt 3g

New York, NY 10044-0406

Additional practice locations (1)

535 East 73rd St
New York, NY 10044
Phone: (646) 608-3824
Fax: (646) 227-7246

Registry dates

Enumerated: 2020-09-16
Last updated: 2020-09-16
Certified: 2020-09-14

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.