Provider Demographics
NPI:1144218793
Name:MAURIELLO, ALFRED J II (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:J
Last Name:MAURIELLO
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:15 INDUSTRIAL BLVD
Mailing Address - Street 2:STE 102
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1608
Mailing Address - Country:US
Mailing Address - Phone:610-363-2532
Mailing Address - Fax:610-363-0210
Practice Address - Street 1:15 INDUSTRIAL BLVD
Practice Address - Street 2:STE 102
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1608
Practice Address - Country:US
Practice Address - Phone:610-363-2532
Practice Address - Fax:610-363-0210
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2018-04-26
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Provider Licenses
StateLicense IDTaxonomies
PAMD011731E207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006068850001Medicaid
PA116714K61Medicare PIN
PA0006068850001Medicaid