Provider Demographics
NPI:1821056151
Name:TRIOLO, PAUL (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:TRIOLO
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 1:181 NATHAN DR
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-2213
Mailing Address - Country:US
Mailing Address - Phone:732-323-0100
Mailing Address - Fax:732-970-6338
Practice Address - Street 1:2292 CLOVER HILL LN
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-1393
Practice Address - Country:US
Practice Address - Phone:732-323-0100
Practice Address - Fax:732-818-9741
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05532400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
142132ZCEFMedicare PIN
E95193Medicare UPIN