Provider Demographics
NPI:1225466626
Name:CAROL M. D'AQUINO, M.D., P.C.
Entity Type:Organization
Organization Name:CAROL M. D'AQUINO, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:M
Authorized Official - Last Name:D'AQUINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-666-9600
Mailing Address - Street 1:261 OLD HOOK RD
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-3102
Mailing Address - Country:US
Mailing Address - Phone:201-666-9600
Mailing Address - Fax:201-666-5014
Practice Address - Street 1:261 OLD HOOK RD
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-3102
Practice Address - Country:US
Practice Address - Phone:201-666-9600
Practice Address - Fax:201-666-5014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-22
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA054859207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJB40231Medicare UPIN
NJ633206Medicare PIN