Provider Demographics
NPI:1770685414
Name:AQUILINO, LINDA (DO)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:AQUILINO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1652 COOPER ST
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-3768
Mailing Address - Country:US
Mailing Address - Phone:856-227-8611
Mailing Address - Fax:856-227-5716
Practice Address - Street 1:1652 COOPER ST
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-3768
Practice Address - Country:US
Practice Address - Phone:856-227-8611
Practice Address - Fax:856-227-5716
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8766003Medicaid
NJ56953Medicare ID - Type Unspecified
NJH58703Medicare UPIN