Provider Demographics
NPI:1144344672
Name:AGUIRRE, FRANK J (MD)
Entity type:Individual
Prefix:MR
First Name:FRANK
Middle Name:J
Last Name:AGUIRRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-1265
Mailing Address - Country:US
Mailing Address - Phone:908-558-7366
Mailing Address - Fax:908-354-4987
Practice Address - Street 1:830 PARK AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-1265
Practice Address - Country:US
Practice Address - Phone:908-558-7366
Practice Address - Fax:908-354-4987
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05485300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ703871Medicare ID - Type Unspecified
NJF12201Medicare UPIN