MEDICARE: DR. WILLIAM CARL DEANGELO DC

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	111N00000X	Chiropractor	000912	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	050000912CT01	OTHER	CT	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851386577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM CARL DEANGELO DC

Provider Business Mailing Address
First Line	:	531 NEW HAVEN AVE
Second Line	:
City	:	MILFORD
State	:	CT
Zip	:	06460-8613
Country	:	US
Telephone Number	:	203-878-7800
Fax Number	:	203-878-8849

Provider Business Practice Location Address
First Line	:	531 NEW HAVEN AVE
Second Line	:
City	:	MILFORD
State	:	CT
Zip	:	06460-8613
Country	:	US
Telephone Number	:	203-878-7800
Fax Number	:	203-878-8849

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

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	10/31/2013

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Directions to “ DR. WILLIAM CARL DEANGELO DC” Practice Location

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