Provider Demographics
NPI:1447024468
Name:PAOLERCIO, MICHAEL ANTHONY I
Entity type:Individual
Prefix:MR
First Name:MICHAEL ANTHONY
Middle Name:
Last Name:PAOLERCIO
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 NORTH ALBANY AVE., UNIT 1
Mailing Address - Street 2:FLOOR 1
Mailing Address - City:ATLANTIC CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08401
Mailing Address - Country:US
Mailing Address - Phone:862-271-9417
Mailing Address - Fax:609-328-9447
Practice Address - Street 1:21 NORTH ALBANY AVE., UNIT 1
Practice Address - Street 2:FLOOR 1
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401
Practice Address - Country:US
Practice Address - Phone:862-271-9417
Practice Address - Fax:609-328-9447
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No171W00000XOther Service ProvidersContractor
No1744P3200XOther Service ProvidersSpecialistProsthetics Case Management