Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 050386 | CT |
N | 208000000X | Pediatrician | 234800 | NY |
NPI | 1013007194 |
---|---|
Provider Name | Dr. Joanne Angiello |
First Address | Ridgefield, CT 06877 |
Second Address | Ridgefield, CT 06877 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 08/11/2011 |