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General NPI Number Information
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NPI Number | 1184931404
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Entity Type | Individual
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Provider Name | PATRICIA AGUAYO M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/08/2010
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Last Update Date | 10/16/2021
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Provider Practice Location Address
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Address Line | 2150 CORBIN AVE
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City | NEW BRITAIN
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State | CT
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Zip | 06053-2266
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Country | US
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Telephone | 860-612-6386
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Fax |
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Provider Business Mailing Address
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Address Line | 2150 CORBIN AVE
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City | NEW BRITAIN
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State | CT
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Zip | 06053-2266
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Country | US
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Telephone | 860-612-6386
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 050018
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 050018
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 10462938-8905
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License Number State | UT
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