Provider Demographics
NPI:1912657081
Name:AGUIAR, GIOVANI S (CRNP)
Entity Type:Individual
Prefix:MR
First Name:GIOVANI
Middle Name:S
Last Name:AGUIAR
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 E NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-1517
Mailing Address - Country:US
Mailing Address - Phone:410-675-2113
Mailing Address - Fax:410-675-2117
Practice Address - Street 1:2401 E NORTH AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-1517
Practice Address - Country:US
Practice Address - Phone:410-675-2113
Practice Address - Fax:410-675-2117
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR199330363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty