Provider Demographics
NPI:1659125581
Name:QUIJANO, MICHELLE AQUINO (RPH)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:AQUINO
Last Name:QUIJANO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 S WOOD AVE APT 210
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-3172
Mailing Address - Country:US
Mailing Address - Phone:848-333-9517
Mailing Address - Fax:
Practice Address - Street 1:1133 INMAN AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1282
Practice Address - Country:US
Practice Address - Phone:908-753-0624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04338500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist