Provider Demographics
NPI:1710218185
Name:AQUILINA, JOSEPH WOLFGANG (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:WOLFGANG
Last Name:AQUILINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 SADDLE LN
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-3120
Mailing Address - Country:US
Mailing Address - Phone:610-515-8656
Mailing Address - Fax:
Practice Address - Street 1:76 SADDLE LN
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-3120
Practice Address - Country:US
Practice Address - Phone:610-515-8656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-24
Last Update Date:2010-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417701208800000X
MI4301405801208800000X
MN38093208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology