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General NPI Number Information
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NPI Number | 1851592927
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Entity Type | Individual
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Provider Name | ANGELA V PANTELIAS RPA-C
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Gender | Female
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 15211 89TH AVE 2ND FLOOR ORTHOPAEDICS
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City | JAMAICA
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State | NY
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Zip | 11432-3730
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Country | US
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Telephone | 718-558-7240
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Fax | 718-558-6181
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Provider Business Mailing Address
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Address Line | 202 FRIEDENSTEIN RD
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City | LONG EDDY
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State | NY
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Zip | 12760-5906
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Country | US
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Telephone | 845-887-2060
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0037321
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License Number State | NY
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