Provider Demographics
NPI:1093786121
Name:AQUINO, MICHAEL P (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:P
Last Name:AQUINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1907 HIGHWAY 35
Mailing Address - Street 2:SUITE 1
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-2765
Mailing Address - Country:US
Mailing Address - Phone:732-517-0060
Mailing Address - Fax:732-380-1965
Practice Address - Street 1:1907 HIGHWAY 35
Practice Address - Street 2:SUITE 1
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-2765
Practice Address - Country:US
Practice Address - Phone:732-517-0060
Practice Address - Fax:732-380-1965
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJBA3359052207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0301672000OtherAMERIHEALTH PROVIDER #
NJ5825039OtherAETNA PROVIDER ID#
NJOK9528OtherHEALTHNET PROVIDER #
NJ6721401Medicaid
NJZ499985OtherGHI PROVIDER #
NJP683740OtherOXFORD PROVIDER #
NJ0301672000OtherAMERIHEALTH PROVIDER #
NJ5825039OtherAETNA PROVIDER ID#