Provider Demographics
NPI:1902659337
Name:AGUILAR, CHRISTIAN (PA-C, RDN)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:AGUILAR
Suffix:
Gender:M
Credentials:PA-C, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 GIFFORD AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIMANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06226-3425
Mailing Address - Country:US
Mailing Address - Phone:860-634-1821
Mailing Address - Fax:
Practice Address - Street 1:49 GIFFORD AVE
Practice Address - Street 2:
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226-3425
Practice Address - Country:US
Practice Address - Phone:860-634-1821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant