Provider Demographics
NPI:1861596173
Name:AQUINO, ROSLYNN REYES (MS ANPC)
Entity type:Individual
Prefix:
First Name:ROSLYNN
Middle Name:REYES
Last Name:AQUINO
Suffix:
Gender:F
Credentials:MS ANPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 KNIGHTSBRIDGE RD APT 1B
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-4504
Mailing Address - Country:US
Mailing Address - Phone:917-402-1342
Mailing Address - Fax:
Practice Address - Street 1:600 COMMUNITY DRIVE
Practice Address - Street 2:HEALTH SOLUTIONS
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030
Practice Address - Country:US
Practice Address - Phone:516-719-5211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF303182-1163W00000X
NYF303182363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
P60853Medicare UPIN
NM2E6641Medicare ID - Type Unspecified