Basic Information
| Provider Information | |||||||||
| NPI: | 1710227673 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PATRICK D AIELLO MD LLC | ||||||||
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| OtherOrganizationName: | AIELLO EYE INSTITUTE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 275 W 28TH ST | ||||||||
| Address2: | |||||||||
| City: | YUMA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853647308 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9287821980 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11551 S FORTUNA RD | ||||||||
| Address2: | STE E | ||||||||
| City: | YUMA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853677853 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9285037057 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2013 | ||||||||
| LastUpdateDate: | 02/28/2013 | ||||||||
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| AuthorizedOfficialLastName: | AIELLO | ||||||||
| AuthorizedOfficialFirstName: | MARLENE | ||||||||
| AuthorizedOfficialMiddleName: | DENISE | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9285037057 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | R.N. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 21328 | AZ | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.