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General NPI Number Information
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NPI Number | 1639435126
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Entity Type | Individual
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Provider Name | ELVIN DANIEL AGUILAR CRNA
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Gender | Male
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Dates
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Enumeration Date | 04/09/2012
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Last Update Date | 04/09/2012
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Provider Practice Location Address
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Address Line | DEPARTMENT OF ANESTHESIOLOGY STONY BROOK UNIVERSITY HOSPITAL
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City | STONY BROOK
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State | NY
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Zip | 11794-8081
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Country | US
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Telephone | 631-708-6140
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2174
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City | SAINT JAMES
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State | NY
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Zip | 11780-0606
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Country | US
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Telephone | 407-927-5151
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 638816
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License Number State | NY
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