Provider Demographics
NPI:1194187666
Name:AGUILERA GALVIZ, FABIOLA (MD)
Entity type:Individual
Prefix:
First Name:FABIOLA
Middle Name:
Last Name:AGUILERA GALVIZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FABIOLA
Other - Middle Name:
Other - Last Name:AGUILERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1776 EASTCHESTER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2334
Mailing Address - Country:US
Mailing Address - Phone:917-801-5577
Mailing Address - Fax:917-801-5594
Practice Address - Street 1:1776 EASTCHESTER RD STE 200
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2334
Practice Address - Country:US
Practice Address - Phone:917-801-5577
Practice Address - Fax:917-801-5594
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3294302086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery