Provider Demographics
NPI:1912215559
Name:AQUINO, RAFAEL
Entity type:Individual
Prefix:MR
First Name:RAFAEL
Middle Name:
Last Name:AQUINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-1512
Mailing Address - Country:US
Mailing Address - Phone:203-574-3986
Mailing Address - Fax:203-597-5459
Practice Address - Street 1:26 N ELM ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-1512
Practice Address - Country:US
Practice Address - Phone:203-574-3986
Practice Address - Fax:203-597-5459
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker