=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619911906
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RAUL FRANCISCO AGUILAR M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/16/2006
-----------------------------------------------------
Last Update Date | 02/05/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 308 WILLOW AVE FL 1
-----------------------------------------------------
City | HOBOKEN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07030-3808
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-798-4044
-----------------------------------------------------
Fax | 201-798-3358
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 129 WASHINGTON ST SUITE 200
-----------------------------------------------------
City | HOBOKEN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07030-4657
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-798-4044
-----------------------------------------------------
Fax | 201-798-3358
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | MA46205
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 25MA04620500
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------