Provider Demographics
NPI:1740020361
Name:ESQUILIN, MARIAIDA
Entity type:Individual
Prefix:
First Name:MARIAIDA
Middle Name:
Last Name:ESQUILIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2669 CLEAR FORK RD
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-9642
Mailing Address - Country:US
Mailing Address - Phone:352-322-6019
Mailing Address - Fax:
Practice Address - Street 1:2669 CLEAR FORK RD
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-9642
Practice Address - Country:US
Practice Address - Phone:352-322-6019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant