MEDICARE: PAUL A. AIELLO M.D.

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	2085R0202X	Diagnostic Radiology Physician	028571	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366447302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL A. AIELLO M.D.

Provider Business Mailing Address
First Line	:	PO BOX 6128
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06606-0128
Country	:	US
Telephone Number	:	203-683-4500
Fax Number	:	203-926-1410

Provider Business Practice Location Address
First Line	:	4699 MAIN ST
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06606-1830
Country	:	US
Telephone Number	:	203-683-4550
Fax Number	:	203-926-1410

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	03/07/2017

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