Provider Demographics
NPI:1740376854
Name:PAUL T. AQUINO, PHD, PSYCHOLOGIST, PC
Entity type:Organization
Organization Name:PAUL T. AQUINO, PHD, PSYCHOLOGIST, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:T
Authorized Official - Last Name:AQUINO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:914-474-6651
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012728-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYXXXXX9262OtherUNITED BEHAVIORAL HEALTH
NYV0438OtherEMPIRE BC/BS
NY01708790Medicaid
NYUNITED AMERICANOtherUNITED AMERICAN
NY01708790Medicaid