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NPI Code Detail

MEDICARE: MATTHEW AIELLO ATC

MEDICARE: MATTHEW AIELLO ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer096003129IL

General Provider Information

NPI Number : 1225550346
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW AIELLO ATC
Provider Business Mailing Address
First Line : 650 N ACADEMY ST
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-2246
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5540 CENTERVIEW DR STE 200
Second Line :
City : RALEIGH
State : NC
Zip : 27606-3386
Country : US
Telephone Number : 224-678-4532
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2017
Last Update Date : 08/05/2025

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