Provider Demographics
NPI:1053353995
Name:AQUILIO, ERNEST JOHN (DO)
Entity type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:JOHN
Last Name:AQUILIO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 HORSENECK RD
Mailing Address - Street 2:
Mailing Address - City:MONTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07045-9303
Mailing Address - Country:US
Mailing Address - Phone:973-335-3230
Mailing Address - Fax:973-335-7335
Practice Address - Street 1:74 HORSENECK RD
Practice Address - Street 2:
Practice Address - City:MONTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07045-9303
Practice Address - Country:US
Practice Address - Phone:973-335-3230
Practice Address - Fax:973-335-7335
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB22168207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2079607Medicaid
NJE06255Medicare UPIN
NJ456281Medicare ID - Type Unspecified