Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 159613 | NY |
Y | 2080P0205X | Pediatric Endocrinologist | 159613 | NY |
NPI | 1477573269 |
---|---|
Provider Name | Moris Alejandro Angulo |
First Address | Mineola, NY 11501-3808 |
Second Address | Mineola, NY 11501-4073 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 04/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01244435 | (05) | NY |
A60485 | (02) | NY |