Provider Demographics
NPI:1336247394
Name:AQUINO, PAUL T (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:T
Last Name:AQUINO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 CHELSEA RD
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-5454
Mailing Address - Country:US
Mailing Address - Phone:914-474-6651
Mailing Address - Fax:845-838-0536
Practice Address - Street 1:126 CHELSEA RD
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-5454
Practice Address - Country:US
Practice Address - Phone:914-474-6651
Practice Address - Fax:845-838-0536
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012728-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC V04381OtherUNITED AMERICAN
NY01708790Medicaid
NYXXXXX9262OtherUNITED BEHAVIORAL HEALTH
NYV0438OtherEMPIRE BC/BS
NYV0438OtherEMPIRE BC/BS