Healthcare Provider Details

I. General information

NPI: 1750100434
Provider Name (Legal Business Name): NATALIE ANGELO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2024
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 IRON BRIDGE RD STE 4
FREEHOLD NJ
07728-5305
US

IV. Provider business mailing address

501 IRON BRIDGE RD STE 4
FREEHOLD NJ
07728-5305
US

V. Phone/Fax

Practice location:
  • Phone: 732-920-3434
  • Fax:
Mailing address:
  • Phone: 732-920-3434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number35SI00815900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: