Provider Demographics
NPI:1093319436
Name:ANGELUCCI, ANTHONY ERNEST
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:ERNEST
Last Name:ANGELUCCI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 MANTEL DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-5203
Mailing Address - Country:US
Mailing Address - Phone:610-563-8556
Mailing Address - Fax:
Practice Address - Street 1:760 MILES RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-1950
Practice Address - Country:US
Practice Address - Phone:610-429-3477
Practice Address - Fax:610-696-7399
Is Sole Proprietor?:No
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP444795183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist