Provider Demographics
NPI:1568551513
Name:WALTER PALADINO MD LLC
Entity Type:Organization
Organization Name:WALTER PALADINO MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:P
Authorized Official - Last Name:PALADINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-744-2883
Mailing Address - Street 1:540 PARMALEE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44510-1717
Mailing Address - Country:US
Mailing Address - Phone:330-744-2883
Mailing Address - Fax:330-744-3935
Practice Address - Street 1:540 PARMALEE AVE
Practice Address - Street 2:STE 200
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44510-1605
Practice Address - Country:US
Practice Address - Phone:330-744-2883
Practice Address - Fax:330-744-3935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35072120P174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2009687Medicaid
OHB39617Medicare UPIN
OH2009687Medicaid