Provider Demographics
NPI:1891722328
Name:AULICINO, PAT LOUIS (MD)
Entity Type:Individual
Prefix:
First Name:PAT
Middle Name:LOUIS
Last Name:AULICINO
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 1:200 MEDICAL PKWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4911
Mailing Address - Country:US
Mailing Address - Phone:757-547-9721
Mailing Address - Fax:757-547-2544
Practice Address - Street 1:200 MEDICAL PKWY
Practice Address - Street 2:SUITE 210
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4911
Practice Address - Country:US
Practice Address - Phone:757-547-9721
Practice Address - Fax:757-547-2544
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034042207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6439764Medicaid
VA400000005Medicare ID - Type Unspecified
VA6439764Medicaid