Provider Demographics
NPI:1033531470
Name:PAOLICELLI, DINO
Entity Type:Individual
Prefix:
First Name:DINO
Middle Name:
Last Name:PAOLICELLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:466 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10307-1728
Mailing Address - Country:US
Mailing Address - Phone:917-763-7551
Mailing Address - Fax:
Practice Address - Street 1:466 MAIN ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10307-1728
Practice Address - Country:US
Practice Address - Phone:917-763-7551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-18
Last Update Date:2014-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist