Healthcare Provider Details

I. General information

NPI: 1003733791
Provider Name (Legal Business Name): ANGELA BAILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

580 WHITE PLAINS RD STE 510
TARRYTOWN NY
10591-5152
US

IV. Provider business mailing address

47 STETSON RD
RINGWOOD NJ
07456-2316
US

V. Phone/Fax

Practice location:
  • Phone: 201-790-3938
  • Fax:
Mailing address:
  • Phone: 201-790-3938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: