Provider Demographics
NPI:1285952127
Name:ACQUILANO, JAMES PAUL (PSYD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:PAUL
Last Name:ACQUILANO
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7931 BAPTIST HILL RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14469-9724
Mailing Address - Country:US
Mailing Address - Phone:585-657-7449
Mailing Address - Fax:
Practice Address - Street 1:7931 BAPTIST HILL RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NY
Practice Address - Zip Code:14469-9724
Practice Address - Country:US
Practice Address - Phone:585-657-7449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-15
Last Update Date:2010-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018584103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical