Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 01060778A | IN |
Y | 207L00000X | Anesthesiologist | 261163 | NY |
N | 207L00000X | Anesthesiologist | D0066871 | MD |
NPI | 1013126093 |
---|---|
Provider Name | Dr. Michael Philip Angelucci |
First Address | Glens Falls, NY 12801-4447 |
Second Address | Glens Falls, NY 12801-4413 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 16/12/2021 |