Provider Demographics
NPI:1013296193
Name:AIELLO, JEANNINE (MS ED)
Entity Type:Individual
Prefix:MS
First Name:JEANNINE
Middle Name:
Last Name:AIELLO
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 E 20TH ST APT 7G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-1324
Mailing Address - Country:US
Mailing Address - Phone:212-786-4984
Mailing Address - Fax:
Practice Address - Street 1:530 E 20TH ST APT 7G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-1324
Practice Address - Country:US
Practice Address - Phone:212-786-4984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2016-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY606614051222Q00000X
NY025550-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist