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General NPI Number Information
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NPI Number | 1851766000
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Entity Type | Organization
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Legal Business Name | J. M. AQUINO PSYCHOLOGIST PLLC
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Dates
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Enumeration Date | 12/13/2015
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Last Update Date | 12/13/2015
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Provider Practice Location Address
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Address Line | 10 RYE RIDGE PLZ SUITE 214
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City | RYE BROOK
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State | NY
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Zip | 10573-2828
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Country | US
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Telephone | 914-253-9429
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Fax | 914-777-3852
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Provider Business Mailing Address
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Address Line | 10 RYE RIDGE PLZ SUITE 214
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City | RYE BROOK
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State | NY
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Zip | 10573-2828
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Country | US
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Telephone | 914-253-9429
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Fax | 914-777-3852
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. JOSEPH MARIO AQUINO
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Credential | PH. D.
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Telephone | 914-253-0429
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 009291
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License Number State | NY
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