Provider Demographics
NPI:1710227673
Name:PATRICK D AIELLO MD LLC
Entity Type:Organization
Organization Name:PATRICK D AIELLO MD LLC
Other - Org Name:AIELLO EYE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:AIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:928-503-7057
Mailing Address - Street 1:275 W 28TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7308
Mailing Address - Country:US
Mailing Address - Phone:928-782-1980
Mailing Address - Fax:
Practice Address - Street 1:11551 S FORTUNA RD
Practice Address - Street 2:STE E
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85367-7853
Practice Address - Country:US
Practice Address - Phone:928-503-7057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21328207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty