Provider Demographics
NPI:1740428515
Name:AQUILINA, GRETCHEN R (DO)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:R
Last Name:AQUILINA
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7202 GLEN FOREST DR STE 200
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3780
Mailing Address - Country:US
Mailing Address - Phone:804-673-0134
Mailing Address - Fax:804-200-6229
Practice Address - Street 1:10710 MIDLOTHIAN TPKE STE 138
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-4766
Practice Address - Country:US
Practice Address - Phone:804-348-2814
Practice Address - Fax:855-815-0304
Is Sole Proprietor?:No
Enumeration Date:2009-01-31
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102203421208600000X
VA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery