Provider Demographics
NPI:1437294659
Name:AIELLO, NEIL WESLEY (MA)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:WESLEY
Last Name:AIELLO
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1149 N EDISON ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-1375
Mailing Address - Country:US
Mailing Address - Phone:509-736-4005
Mailing Address - Fax:
Practice Address - Street 1:1149 N EDISON ST
Practice Address - Street 2:SUITE D
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-1375
Practice Address - Country:US
Practice Address - Phone:509-736-4005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD00002478237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA198097OtherDEPT. LABOR & INDUSTRIES
WA90485339Medicaid
WALD00002478OtherAUDIOLOGY LICENSE
WA7099757Medicaid