Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 0101-233892 | VA |
Y | 2080P0201X | Pediatric Allergist | 0101-233892 | VA |
NPI | 1902878275 |
---|---|
Provider Name | Angela Ang-Alhadeff |
First Address | Roanoke, VA 24018-7686 |
Second Address | Roanoke, VA 24013-2254 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2006 |
Last Update Date | 07/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010015880 | (05) | VA |
H96669 | (02) | VA |