Healthcare Provider Details

I. General information

NPI: 1801717731
Provider Name (Legal Business Name): ANGELINA K FOX
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: MATTHEW FOX

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

629 E WOOD ST STE 205
VINELAND NJ
08360-3752
US

IV. Provider business mailing address

629 E WOOD ST STE 205
VINELAND NJ
08360-3752
US

V. Phone/Fax

Practice location:
  • Phone: 856-839-0881
  • Fax:
Mailing address:
  • Phone: 856-839-0881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: