Provider Demographics
NPI:1366444754
Name:AIELLO, THOMAS CONRAD (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CONRAD
Last Name:AIELLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8723 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-5103
Mailing Address - Country:US
Mailing Address - Phone:718-836-2001
Mailing Address - Fax:718-836-8210
Practice Address - Street 1:8723 3RD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-5103
Practice Address - Country:US
Practice Address - Phone:718-836-2001
Practice Address - Fax:718-836-8210
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2021-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198895207W00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY17N0811OtherNEIGHBORHOOD HEALTH PLAN
NY168281OtherEMPIRE BLUE CROSS
NY252850201OtherHEALTHPLUS
NY32478POtherHIP
NY565897OtherAETNA
NY11224OtherELDERPLAN
NY1311820OtherUNITED HEALTHCARE
NYP379029OtherOXFORD
NY180024779OtherRAILROAD MEDICARE
NY44725785OtherATLANTIS
NY0400968OtherGHI
NY112320974-A107OtherCARE PLUS
NY6241886001OtherCIGNA
NY198895-A15OtherHEALTHFIRST
NY01591639Medicaid
NY1C0855OtherHEALTHNET
NY0400968OtherGHI
NY6241886001OtherCIGNA
NY01591639Medicaid