Provider Demographics
NPI:1225194111
Name:AIELLO, MARIA THERESE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:THERESE
Last Name:AIELLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7423 SHORE RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-1919
Mailing Address - Country:US
Mailing Address - Phone:718-836-2001
Mailing Address - Fax:718-836-8210
Practice Address - Street 1:7423 SHORE RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-1919
Practice Address - Country:US
Practice Address - Phone:718-836-2001
Practice Address - Fax:718-836-8210
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY122999174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC08469Medicare UPIN
NY323431Medicare ID - Type Unspecified