Basic Information
Provider Information
NPI: 1528257565
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AIELLO
FirstName: ANNETTE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 43 KENWOOD TER
Address2:  
City: TRENTON
State: NJ
PostalCode: 086102512
CountryCode: US
TelephoneNumber: 6095858210
FaxNumber:  
Practice Location
Address1: 2250 HICKORY RD
Address2: SUITE 240
City: PLYMOUTH MEETING
State: PA
PostalCode: 194621047
CountryCode: US
TelephoneNumber: 6108341122
FaxNumber: 6108347525
Other Information
ProviderEnumerationDate: 10/16/2007
LastUpdateDate: 10/16/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X26NO10393500NJY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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