Provider Demographics
NPI:1366569774
Name:EDWIN A. AQUINO, M.D., P.C.
Entity type:Organization
Organization Name:EDWIN A. AQUINO, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:ABELLA
Authorized Official - Last Name:AQUINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-541-5406
Mailing Address - Street 1:845 SIR THOMAS CT
Mailing Address - Street 2:SUITE 10
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-4840
Mailing Address - Country:US
Mailing Address - Phone:717-541-5406
Mailing Address - Fax:717-541-5449
Practice Address - Street 1:845 SIR THOMAS CT
Practice Address - Street 2:SUITE 10
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4840
Practice Address - Country:US
Practice Address - Phone:717-541-5406
Practice Address - Fax:717-541-5449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD027976E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty