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General NPI Number Information
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NPI Number | 1679689525
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Entity Type | Individual
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Provider Name | JUDY ANN D'ANGELO ANP
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Gender | Female
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 601 ELMWOOD AVE BOX 619
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City | ROCHESTER
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State | NY
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Zip | 14642-0001
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Country | US
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Telephone | 585-275-3933
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Fax |
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Provider Business Mailing Address
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Address Line | 80 BRANDYWINE LN
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City | ROCHESTER
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State | NY
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Zip | 14618-5602
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Country | US
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Telephone | 585-271-7014
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F304049-1
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License Number State | NY
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