MEDICARE: DR. MICHAEL D AQUINO DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	N003386	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8903879	OTHER	NY	INDEPENDENT HEALTH
3	000500064001	OTHER	NY	BLUE CROSS/BLUE SHIELD
4	00010250601	OTHER	NY	UNIVERA
5	0079077	OTHER	NY	GHI
6	050110000141	OTHER	NY	FIDELIS

General Provider Information

NPI Number	:	1720046253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL D AQUINO DPM

Provider Business Mailing Address
First Line	:	929 BRIGHTON RD
Second Line	:
City	:	TONAWANDA
State	:	NY
Zip	:	14150-8113
Country	:	US
Telephone Number	:	716-837-1500
Fax Number	:	716-837-0799

Provider Business Practice Location Address
First Line	:	564 NIAGARA ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14201-1108
Country	:	US
Telephone Number	:	716-884-1325
Fax Number	:	716-837-0799

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	07/08/2007

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