Provider Demographics
NPI:1235375536
Name:PATRICK D AIELLO MD LLC
Entity type:Organization
Organization Name:PATRICK D AIELLO MD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:D
Authorized Official - Last Name:AIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:782-503-0332
Mailing Address - Street 1:275 W. 28TH ST.
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7308
Mailing Address - Country:US
Mailing Address - Phone:928-782-1980
Mailing Address - Fax:928-345-2950
Practice Address - Street 1:275 W. 28TH ST.
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7308
Practice Address - Country:US
Practice Address - Phone:928-782-1980
Practice Address - Fax:928-345-2950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-17
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21328207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty