Provider Demographics
NPI:1699033050
Name:RONALD AIELLO, D.O, INC.
Entity Type:Organization
Organization Name:RONALD AIELLO, D.O, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:P
Authorized Official - Last Name:AIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:330-792-5247
Mailing Address - Street 1:5208 MAHONING AVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-1858
Mailing Address - Country:US
Mailing Address - Phone:330-792-5247
Mailing Address - Fax:
Practice Address - Street 1:5208 MAHONING AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-1858
Practice Address - Country:US
Practice Address - Phone:330-792-5247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-23
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-1999207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0408142Medicaid