Healthcare Provider Details

I. General information

NPI: 1811226160
Provider Name (Legal Business Name): ANTHONY D'ANGELO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2009
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27A W MERRICK RD
FREEPORT NY
11520-3826
US

IV. Provider business mailing address

27A W MERRICK RD
FREEPORT NY
11520-3826
US

V. Phone/Fax

Practice location:
  • Phone: 516-223-3195
  • Fax: 516-223-3196
Mailing address:
  • Phone: 516-223-3195
  • Fax: 516-223-3196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number254672
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: