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General NPI Number Information
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NPI Number | 1992917819
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Entity Type | Individual
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Provider Name | SUSAN AIELLO NP
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Gender | Female
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 08/14/2007
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Provider Practice Location Address
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Address Line | STONY BROOK DEPT OF RADIOLOGY HSC LEVEL 4, ROOM 120
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City | STONY BROOK
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State | NY
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Zip | 11794-8460
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Country | US
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Telephone | 631-444-2426
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Fax | 631-444-7538
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Provider Business Mailing Address
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Address Line | STONY BROOK DEPT OF RADIOLOGY HSC LEVEL 4, ROOM 120
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City | STONY BROOK
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State | NY
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Zip | 11794-8460
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Country | US
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Telephone | 631-444-2426
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Fax | 631-444-7538
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 5799828
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 5499577
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | F381289
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License Number State | NY
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