1629533278 NPI number — AYLWIN VASQUEZ-PAPARO

Table of content: AYLWIN VASQUEZ-PAPARO (NPI 1629533278)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629533278 NPI number — AYLWIN VASQUEZ-PAPARO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VASQUEZ-PAPARO
Provider First Name:
AYLWIN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629533278
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/17/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
772 JACQUELINE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOMS RIVER
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08753-5695
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
347-827-7945
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
90 EAST HALSEY RD, STE 333 #2273
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARSIPANNY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-232-5795
Provider Business Practice Location Address Fax Number:
609-901-3544
Provider Enumeration Date:
02/07/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  40QA01516500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)