Provider Demographics
NPI:1558541326
Name:AIELLO, TRICIA (DC)
Entity Type:Individual
Prefix:DR
First Name:TRICIA
Middle Name:
Last Name:AIELLO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-5032
Mailing Address - Country:US
Mailing Address - Phone:516-557-2175
Mailing Address - Fax:516-557-2173
Practice Address - Street 1:635 BROADWAY
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-5032
Practice Address - Country:US
Practice Address - Phone:516-557-2175
Practice Address - Fax:516-557-2173
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-09
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011264111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor