Basic Information
| Provider Information | |||||||||
| NPI: | 1235601329 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AIELLO | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | JAMES | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 582 ROOSEVELT TRL | ||||||||
| Address2: | |||||||||
| City: | WINDHAM | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040624904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2078923233 | ||||||||
| FaxNumber: | 2078930752 | ||||||||
| Practice Location | |||||||||
| Address1: | 582 ROOSEVELT TRL | ||||||||
| Address2: | |||||||||
| City: | WINDHAM | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040624904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2078923233 | ||||||||
| FaxNumber: | 2078930752 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/30/2018 | ||||||||
| LastUpdateDate: | 06/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | PA2362 | ME | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.