Provider Demographics
NPI:1154326197
Name:CUMELLA, ANGELO (MD)
Entity Type:Individual
Prefix:
First Name:ANGELO
Middle Name:
Last Name:CUMELLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:CAREMOUNT MEDICAL PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:185 ROUTE 312
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-2337
Practice Address - Country:US
Practice Address - Phone:845-278-7000
Practice Address - Fax:845-278-2212
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167742-1174400000X
NY167742207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01050297Medicaid
NY01050297Medicaid
NY09E2506761Medicare PIN
NY0667910001OtherDME
NY09E251Medicare PIN