Healthcare Provider Details

I. General information

NPI: 1225505167
Provider Name (Legal Business Name): AMANDA ANGELOZZI CNIM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2018
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5080 SPECTRUM DR STE 1100E
ADDISON TX
75001-4688
US

IV. Provider business mailing address

3308 WILLIAMSTOWN RD
FRANKLINVILLE NJ
08322-2810
US

V. Phone/Fax

Practice location:
  • Phone: 215-860-0100
  • Fax:
Mailing address:
  • Phone: 609-774-6144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: