Provider Demographics
NPI:1144967316
Name:DI PIETRO, PAOLO SR (NL, MSC, PHD, RAD)
Entity type:Individual
Prefix:DR
First Name:PAOLO
Middle Name:
Last Name:DI PIETRO
Suffix:SR
Gender:M
Credentials:NL, MSC, PHD, RAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 AVE FERNANDO L RIBAS UNIT 1082
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-3156
Mailing Address - Country:US
Mailing Address - Phone:787-236-0876
Mailing Address - Fax:
Practice Address - Street 1:3 AVE COLON STE 1
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-3378
Practice Address - Country:US
Practice Address - Phone:787-236-0876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR133175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty