Provider Demographics
NPI:1619069739
Name:PAOLONE, VINCENT (MD)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:
Last Name:PAOLONE
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 1:8166 MARKET ST
Mailing Address - Street 2:UNIT B
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-6262
Mailing Address - Country:US
Mailing Address - Phone:330-758-8528
Mailing Address - Fax:330-758-8529
Practice Address - Street 1:8166 MARKET ST
Practice Address - Street 2:UNIT B
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-6262
Practice Address - Country:US
Practice Address - Phone:330-758-8528
Practice Address - Fax:330-758-8529
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350668762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2066142Medicaid
OHPA4150493Medicare PIN
OH2066142Medicaid