Healthcare Provider Details

I. General information

NPI: 1518081785
Provider Name (Legal Business Name): RENEE A. D'ANGELO DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 VILLAGE ROW
NEW HOPE PA
18938-1061
US

IV. Provider business mailing address

9 VILLAGE ROW
NEW HOPE PA
18938-1061
US

V. Phone/Fax

Practice location:
  • Phone: 215-862-6363
  • Fax: 215-862-6361
Mailing address:
  • Phone: 215-862-6363
  • Fax: 215-862-6361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC002958L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: