Provider Demographics
NPI:1316362361
Name:URBINA-AGUILAR, DAVID MAGDIEL JR
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:MAGDIEL
Last Name:URBINA-AGUILAR
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 MUNROE ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1506
Mailing Address - Country:US
Mailing Address - Phone:781-552-0468
Mailing Address - Fax:
Practice Address - Street 1:57 MUNROE ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1506
Practice Address - Country:US
Practice Address - Phone:781-552-0468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker