Provider Demographics
NPI:1952361586
Name:TINELLI, EUGENE THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:THOMAS
Last Name:TINELLI
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 1:4320 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:JAMESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13078-9762
Mailing Address - Country:US
Mailing Address - Phone:315-469-6096
Mailing Address - Fax:
Practice Address - Street 1:4320 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:JAMESVILLE
Practice Address - State:NY
Practice Address - Zip Code:13078-9762
Practice Address - Country:US
Practice Address - Phone:315-469-6096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1536312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry