Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N004631 | NY |
NPI | 1396790648 |
---|---|
Provider Name | Dr. Nicholas D'angelo |
First Address | Brooklyn, NY 11204-3912 |
Second Address | Brooklyn, NY 11204-3912 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01180652 | (05) | NY |
U06153 | (02) | NY |