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General NPI Number Information
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NPI Number | 1932149598
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Entity Type | Individual
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Provider Name | ANTHONY JOSEPH ANGELO M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 8 SUMMERWOOD RD
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City | HOLBROOK
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State | NY
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Zip | 11741-5612
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Country | US
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Telephone | 631-472-1757
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Fax | 631-472-6797
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Provider Business Mailing Address
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Address Line | 8 SUMMERWOOD RD
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City | HOLBROOK
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State | NY
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Zip | 11741
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Country | US
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Telephone | 516-398-9100
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | NY116474
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License Number State | NY
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