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NPI Code Detail

MEDICARE: LANDY PETER PAOLELLA MD

MEDICARE: LANDY PETER PAOLELLA MD
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
12085R0204XVascular & Interventional Radiology PhysicianRI6315RI

Other Identifiers

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

General Provider Information

NPI Number : 1427055987
Entity Type Code : Individual
Provider Name (Legal Business Name) : LANDY PETER PAOLELLA MD
Provider Business Mailing Address
First Line : 1130 TEN ROD RD
Second Line : D201
City : NORTH KINGSTOWN
State : RI
Zip : 02852-4161
Country : US
Telephone Number : 401-295-8655
Fax Number : 401-295-8335
Provider Business Practice Location Address
First Line : 455 TOLL GATE RD
Second Line :
City : WARWICK
State : RI
Zip : 02886-2759
Country : US
Telephone Number : 401-737-1010
Fax Number : 401-736-1974
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 04/07/2008

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