Healthcare Provider Details

I. General information

NPI: 1396789541
Provider Name (Legal Business Name): ANGELA K NAGEL PHARMD, BCPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 08/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

913 CULVER RD CULVER MEDICAL GROUP
ROCHESTER NY
14609-7141
US

IV. Provider business mailing address

913 CULVER RD CULVER MEDICAL GROUP
ROCHESTER NY
14609-7141
US

V. Phone/Fax

Practice location:
  • Phone: 585-654-5432
  • Fax: 585-654-5432
Mailing address:
  • Phone: 585-654-5432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number046911
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberI046911
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: