Provider Demographics
NPI:1457506404
Name:PEREZ-AQUINO, ERLINDA B (MD)
Entity Type:Individual
Prefix:DR
First Name:ERLINDA
Middle Name:B
Last Name:PEREZ-AQUINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DUNBAR
Mailing Address - State:PA
Mailing Address - Zip Code:15431-2063
Mailing Address - Country:US
Mailing Address - Phone:724-628-5337
Mailing Address - Fax:
Practice Address - Street 1:230 DOGWOOD DR
Practice Address - Street 2:
Practice Address - City:DUNBAR
Practice Address - State:PA
Practice Address - Zip Code:15431-2063
Practice Address - Country:US
Practice Address - Phone:724-628-5337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036438L132700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes132700000XDietary & Nutritional Service ProvidersDietary Manager
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPE128019Medicare PIN