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General NPI Number Information
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NPI Number | 1083893689
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Entity Type | Individual
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Provider Name | ANGELA THERESE LANTIN MD
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Gender | Female
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Dates
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Enumeration Date | 10/31/2007
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Last Update Date | 09/03/2016
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Provider Practice Location Address
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Address Line | 755 MEMORIAL PKWY STE 300
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City | PHILLIPSBURG
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State | NJ
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Zip | 08865-2748
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Country | US
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Telephone | 908-454-6303
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Fax | 908-454-2289
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Provider Business Mailing Address
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Address Line | 600 HARMON LOOP RD STE 105
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City | DEDEDO
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State | GU
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Zip | 96929-6536
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Country | US
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Telephone | 671-633-3800
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Fax | 671-633-3801
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M-1992
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License Number State | GU
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A112424
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License Number State | CA
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