Provider Demographics
NPI:1972742435
Name:ROBERT A. PAOLELLA, M.D., INC.
Entity Type:Organization
Organization Name:ROBERT A. PAOLELLA, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUANITA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PAOLELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-345-1492
Mailing Address - Street 1:1515 SMITH ST
Mailing Address - Street 2:SUITE M.
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02911-2947
Mailing Address - Country:US
Mailing Address - Phone:401-354-4384
Mailing Address - Fax:401-354-4390
Practice Address - Street 1:1515 SMITH ST
Practice Address - Street 2:SUITE M.
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02911-2947
Practice Address - Country:US
Practice Address - Phone:401-354-4384
Practice Address - Fax:401-354-4390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-06
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI08017207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty