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General NPI Number Information
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NPI Number | 1508426768
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Entity Type | Organization
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Legal Business Name | DR DAVID ANGELILLO ORTHOPAEDIC SURGERY & SPORTS MEDICINE PC
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Dates
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Enumeration Date | 06/19/2019
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Last Update Date | 06/19/2019
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Provider Practice Location Address
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Address Line | 20001 LINDEN BLVD
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City | SAINT ALBANS
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State | NY
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Zip | 11412-3223
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Country | US
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Telephone | 718-971-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 148 EARL ST
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City | WESTBURY
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State | NY
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Zip | 11590-2945
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Country | US
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Telephone | 516-348-1498
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Fax |
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Authorized Official
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Title or Position | MD/OWNER
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Name | DAVID ANGELILLO
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Credential |
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Telephone | 516-348-1498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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