1215642673 NPI number — DR. ALPHONSE LOUIS PAOLILLO JR. DNP, APRN, FNP-BC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215642673 NPI number — DR. ALPHONSE LOUIS PAOLILLO JR. DNP, APRN, FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PAOLILLO
Provider First Name:
ALPHONSE
Provider Middle Name:
LOUIS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
DNP, APRN, FNP-BC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215642673
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/08/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
149 WATER STREET
Provider Second Line Business Mailing Address:
SUITE 402
Provider Business Mailing Address City Name:
NORWALK
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06854
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-842-2894
Provider Business Mailing Address Fax Number:
203-635-5349

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
149 WATER STREET
Provider Second Line Business Practice Location Address:
SUITE 402
Provider Business Practice Location Address City Name:
NORWALK
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06854
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-842-2894
Provider Business Practice Location Address Fax Number:
203-635-5349
Provider Enumeration Date:
01/20/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  11416 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com