Provider Demographics
NPI:1336639913
Name:AGUIRRE, ESTEFANI S (MSED)
Entity Type:Individual
Prefix:MS
First Name:ESTEFANI
Middle Name:S
Last Name:AGUIRRE
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4117 108TH ST # 2R
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-3475
Mailing Address - Country:US
Mailing Address - Phone:929-285-7846
Mailing Address - Fax:
Practice Address - Street 1:4117 108TH ST # 2R
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-3475
Practice Address - Country:US
Practice Address - Phone:929-285-7846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-18
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist