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NPI Code Detail

MEDICARE: DR. ANITA ANGELO D.O.

MEDICARE: DR. ANITA ANGELO D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianOS008837LPA

General Provider Information

NPI Number : 1073676151
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANITA ANGELO D.O.
Provider Business Mailing Address
First Line : 27 SHADY LN
Second Line :
City : JENKINTOWN
State : PA
Zip : 19046-4264
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2055 E ALLEGHENY AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19134-3832
Country : US
Telephone Number : 215-427-5800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2006
Last Update Date : 07/08/2007

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