Wilson Aguinaldo
Individual provider Active NPI Nurse Practitioner · Bronx, NY
NPI 1508414947 · NPPES record last updated Aug 28, 2019
Key facts
- NPI
- 1508414947
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- F344373-1 (NY)
- Practice address
- 4422 3Rd Ave
Bronx, NY 10457-2545 - Phone
- (718) 960-9000
- NPI assigned
- Aug 28, 2019
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F344373-1 | NY | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | F344373-1 | NY | Yes |
Addresses
Primary practice location
4422 3Rd Ave
Bronx, NY 10457-2545
Mailing address
4422 3Rd Ave
Bronx, NY 10457-2594
Other practice location 1
17 Omni Parc Dr
Nanuet, NY 10954-5950
Phone (845) 271-9563
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.