Provider Demographics
NPI:1083284251
Name:ANGELUCCI, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:ANGELUCCI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 142
Mailing Address - Street 2:
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078-0142
Mailing Address - Country:US
Mailing Address - Phone:443-967-4888
Mailing Address - Fax:
Practice Address - Street 1:111 W MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5514
Practice Address - Country:US
Practice Address - Phone:443-967-4888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health