Alfred J. Mauriello II, M.D.

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

MD011731E Issued in PA

Practice address

15 Industrial Blvd
Ste 102
Paoli, PA 19301-1608

Phone

(610) 363-2532

Fax

(610) 363-0210

NPI assigned

Oct 7, 2005

Last updated

Apr 26, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ear Nose and Throat Associates of Chester County

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  • NPI 1912452079
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524700800000",
    "number": "1144218793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 INDUSTRIAL BLVD",
            "address_2": "STE 102",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011608",
            "telephone_number": "610-363-2532",
            "fax_number": "610-363-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 INDUSTRIAL BLVD",
            "address_2": "STE 102",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011608",
            "telephone_number": "610-363-2532",
            "fax_number": "610-363-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURIELLO",
        "first_name": "ALFRED",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2018-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "PA",
            "license": "MD011731E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006068850001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Otolaryngology/Facial Plastic Surgery Physician in Paoli, PA
• Providers in Paoli, PA by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.