Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 31012 | MA |
Y | 208600000X | Surgeon | 31012 | MA |
N | 2086X0206X | Surgical Oncologist | 31012 | MA |
NPI | 1215237490 |
---|---|
Provider Name | Dr. Carolino Aquino Centeno |
First Address | Westfield, MA 01085 |
Second Address | Westfield, MA 01085 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2010 |
Last Update Date | 22/10/2010 |