Provider Demographics
NPI:1427138940
Name:WILLS, ROSELYN AGUILA (MD)
Entity type:Individual
Prefix:DR
First Name:ROSELYN
Middle Name:AGUILA
Last Name:WILLS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:847 EASTON RD
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-2906
Mailing Address - Country:US
Mailing Address - Phone:215-918-5555
Mailing Address - Fax:215-918-5560
Practice Address - Street 1:847 EASTON RD
Practice Address - Street 2:SUITE 2500
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-2906
Practice Address - Country:US
Practice Address - Phone:215-918-5555
Practice Address - Fax:215-918-5560
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD047717L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA113932OtherBLUE SHIELD
PA8916261003OtherCIGNA
PA0250394000OtherKEYSTONE / IBC
PA2108104OtherAETNA
PA113932OtherBLUE SHIELD
PAF38391Medicare UPIN