Provider Demographics
NPI:1134246861
Name:AGUILA, MARIA (PT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:AGUILA
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 FAIRFAX DR
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-2813
Mailing Address - Country:US
Mailing Address - Phone:201-360-0871
Mailing Address - Fax:201-435-5142
Practice Address - Street 1:391 DANFORTH AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-1984
Practice Address - Country:US
Practice Address - Phone:201-360-0871
Practice Address - Fax:201-435-5142
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01101300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
090457T7VMedicare ID - Type UnspecifiedPROVIDER ID NUMBER
NJJ36570OtherHEALTH NET ID#
090457T7VMedicare ID - Type UnspecifiedPROVIDER ID NUMBER