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General NPI Number Information
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NPI Number | 1578600706
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Entity Type | Organization
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Legal Business Name | E. A. ANGELINI OD LTD
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 10/14/2008
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Provider Practice Location Address
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Address Line | 350 W 6TH ST
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City | RENO
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State | NV
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Zip | 89503-4519
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Country | US
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Telephone | 775-322-4061
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Fax | 775-322-6603
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Provider Business Mailing Address
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Address Line | 350 W 6TH ST
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City | RENO
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State | NV
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Zip | 89503-4519
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Country | US
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Telephone | 775-322-4061
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Fax | 775-322-6603
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Authorized Official
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Title or Position | OWNER-DIRECTOR
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Name | DR. ETTORE ANTHONY ANGELINI
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Credential | O.D.
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Telephone | 775-322-4061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | NV148
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License Number State | NV
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