Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | RN2338961 | MA |
Y | 363L00000X | Nurse Practitioner | RN2338961 | MA |
N | 363LC1500X | Nurse Practitioner - Community Health | RN2338961 | MA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | ARNP9331457 | FL |
NPI | 1760993786 |
---|---|
Provider Name | Patrick Aquino Vergel De Dios |
First Address | Holyoke, MA 01040 |
Second Address | Holyoke, MA 01040 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2017 |
Last Update Date | 22/09/2021 |