Provider Demographics
NPI:1710398235
Name:DE AQUINO, JOAO PAULO (MD)
Entity type:Individual
Prefix:MR
First Name:JOAO
Middle Name:PAULO
Last Name:DE AQUINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOAO
Other - Middle Name:PAULO
Other - Last Name:DE AQUINO LIMA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:49 WOODSTOCK RD
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06517-2949
Mailing Address - Country:US
Mailing Address - Phone:917-346-2928
Mailing Address - Fax:203-937-3472
Practice Address - Street 1:300 GEORGE ST
Practice Address - Street 2:SUITE 901, YALE UNIVERSITY DEPARTMENT OF PSYCHIARTY
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511
Practice Address - Country:US
Practice Address - Phone:203-785-2117
Practice Address - Fax:203-785-7357
Is Sole Proprietor?:No
Enumeration Date:2014-05-19
Last Update Date:2022-01-19
Deactivation Date:2014-12-23
Deactivation Code:
Reactivation Date:2015-02-06
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT554852084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program