Provider Demographics
NPI:1437246170
Name:AQUILLA, JOSEPH B (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:B
Last Name:AQUILLA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:120 SPEER RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-1044
Mailing Address - Country:US
Mailing Address - Phone:410-778-1150
Mailing Address - Fax:410-778-2949
Practice Address - Street 1:120 SPEER RD
Practice Address - Street 2:SUITE 1
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-1044
Practice Address - Country:US
Practice Address - Phone:410-778-1150
Practice Address - Fax:410-778-2949
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2008-05-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD12923207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD415161500Medicaid
MD415161500Medicaid
MD0835860001Medicare NSC