MEDICARE: GENNARO ANTHONY PAOLELLA

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
1	183500000X	Pharmacist	051.300381	IL

General Provider Information

NPI Number	:	1144746660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GENNARO ANTHONY PAOLELLA

Provider Business Mailing Address
First Line	:	PSC 836 BOX 401
Second Line	:
City	:	FPO
State	:	AE
Zip	:	09636-0007
Country	:	US
Telephone Number	:	314-624-4685
Fax Number	:

Provider Business Practice Location Address
First Line	:	PSC 836 BOX 401
Second Line	:
City	:	FPO
State	:	AE
Zip	:	09636-0007
Country	:	US
Telephone Number	:	314-624-4685
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2017
Last Update Date	:	01/28/2025

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Directions to “ GENNARO ANTHONY PAOLELLA ” Practice Location

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