Provider Demographics
NPI:1790757383
Name:MAPELLI, PAOLO (MD)
Entity Type:Individual
Prefix:DR
First Name:PAOLO
Middle Name:
Last Name:MAPELLI
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 1:1312 W MAIN ST
Mailing Address - Street 2:STE 101
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708
Mailing Address - Country:US
Mailing Address - Phone:203-575-0112
Mailing Address - Fax:203-575-0063
Practice Address - Street 1:1312 W MAIN ST
Practice Address - Street 2:STE 101
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708
Practice Address - Country:US
Practice Address - Phone:203-575-0112
Practice Address - Fax:203-575-0063
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT022747207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001227479Medicaid
B37729Medicare UPIN
CT100000371Medicare ID - Type Unspecified