Provider Demographics
NPI:1457663296
Name:AIELLO, DAVID ROBERT (PHD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ROBERT
Last Name:AIELLO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8520 SIX FORKS RD
Mailing Address - Street 2:STE 204
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3095
Mailing Address - Country:US
Mailing Address - Phone:919-676-1497
Mailing Address - Fax:919-676-1430
Practice Address - Street 1:8520 SIX FORKS RD
Practice Address - Street 2:STE 204
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3095
Practice Address - Country:US
Practice Address - Phone:919-676-1497
Practice Address - Fax:919-676-1430
Is Sole Proprietor?:No
Enumeration Date:2010-07-09
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1427103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist