Individual
TIMOTHY PATRICK AIELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NPP
Contact information
Practice address
363 ROUTE 111, SMITHTOWN, NY 11787-4756
(631) 848-1968
Mailing address
938 COATES AVE, HOLBROOK, NY 11741-6025
(631) 312-1362
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402205
NY
Other
Enumeration date
08/01/2017
Last updated
08/01/2017
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