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General NPI Number Information
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NPI Number | 1982146197
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Entity Type | Individual
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Provider Name | MICHELE AQUINO D.P.T.
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Gender | Male
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Dates
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Enumeration Date | 11/07/2016
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 4 BUCCANEER LN
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City | EAST SETAUKET
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State | NY
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Zip | 11733-1806
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Country | US
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Telephone | 516-459-0395
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Fax |
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Provider Business Mailing Address
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Address Line | 4 BUCCANEER LN
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City | EAST SETAUKET
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State | NY
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Zip | 11733-1806
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Country | US
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Telephone | 516-459-0395
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 041103
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License Number State | NY
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