Provider Demographics
NPI:1104835669
Name:AQUILINA, JOSEPH (FNPC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:AQUILINA
Suffix:
Gender:M
Credentials:FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:ME
Mailing Address - Zip Code:04457-0099
Mailing Address - Country:US
Mailing Address - Phone:207-794-6700
Mailing Address - Fax:207-794-6777
Practice Address - Street 1:200 SOMERSET ST
Practice Address - Street 2:SUITE 2
Practice Address - City:MILLINOCKET
Practice Address - State:ME
Practice Address - Zip Code:04462-1258
Practice Address - Country:US
Practice Address - Phone:207-794-6700
Practice Address - Fax:207-794-6777
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP81577363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME431940699Medicaid
MEMM9709Medicare Oscar/Certification
ME201855Medicare Oscar/Certification
ME201837Medicare Oscar/Certification
ME201845Medicare Oscar/Certification
MEQ03497Medicare UPIN
ME431940699Medicaid
ME201836Medicare Oscar/Certification
ME201856Medicare Oscar/Certification