Basic Information
| Provider Information | |||||||||
| NPI: | 1437161874 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AYLOO | ||||||||
| FirstName: | SUBHASHINI | ||||||||
| MiddleName: | MANJULA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 16149 | ||||||||
| Address2: | |||||||||
| City: | RUMFORD | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029160697 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4014539625 | ||||||||
| FaxNumber: | 4014357069 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 DUDLEY ST STE 370 | ||||||||
| Address2: | |||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029053248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4012280560 | ||||||||
| FaxNumber: | 4012280636 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2006 | ||||||||
| LastUpdateDate: | 07/22/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 204F00000X | 036107630 | IL | N | Allopathic & Osteopathic Physicians | Transplant Surgery | 208600000X | 036-107630 | IL | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | MD17356 | RI | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.