Healthcare Provider Details

I. General information

NPI: 1831841881
Provider Name (Legal Business Name): RACHEL A ANGELO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2022
Last Update Date: 01/21/2022
Certification Date: 01/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 1ST AVE
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

71 BAY RIDGE AVE
BROOKLYN NY
11220-5003
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-5790
  • Fax:
Mailing address:
  • Phone: 917-532-0489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberF350548-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: