MEDICARE: CHRISTINA D'ANGELIS P.A.

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
1	363AM0700X	Medical Physician Assistant	004474	NY

General Provider Information

NPI Number	:	1417084682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA D'ANGELIS P.A.

Provider Business Mailing Address
First Line	:	6 PRESLEY ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10308-3239
Country	:	US
Telephone Number	:	718-984-0969
Fax Number	:	718-984-4097

Provider Business Practice Location Address
First Line	:	6 PRESLEY ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10308-3239
Country	:	US
Telephone Number	:	718-984-0969
Fax Number	:	718-984-4097

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	07/08/2007

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Directions to “ CHRISTINA D'ANGELIS P.A.” Practice Location

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