Provider Demographics
NPI:1235614900
Name:PAOLONI, EVA LOUISA (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:EVA
Middle Name:LOUISA
Last Name:PAOLONI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 W MAPLE ST APT 3
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-2869
Mailing Address - Country:US
Mailing Address - Phone:330-554-0482
Mailing Address - Fax:
Practice Address - Street 1:1105 W MAPLE ST APT 3
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-2869
Practice Address - Country:US
Practice Address - Phone:330-554-0482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-28
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.006593RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant