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General NPI Number Information
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NPI Number | 1952817751
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Entity Type | Organization
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Legal Business Name | ANGELA PANG, LLC
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Dates
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Enumeration Date | 12/17/2017
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Last Update Date | 12/17/2017
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Provider Practice Location Address
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Address Line | 94 PLEASANT ST
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City | ARLINGTON
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State | MA
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Zip | 02476-6535
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Country | US
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Telephone | 917-669-9739
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Fax |
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Provider Business Mailing Address
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Address Line | 65 LANARK RD APT 6
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City | BRIGHTON
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State | MA
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Zip | 02135-7841
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ANGELA PANG
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Credential | PSYD
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Telephone | 917-669-9739
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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