Provider Demographics
NPI:1164557765
Name:MACATANGAY, EVANGELINE SORIANO I (MD)
Entity Type:Individual
Prefix:DR
First Name:EVANGELINE
Middle Name:SORIANO
Last Name:MACATANGAY
Suffix:I
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 WELSH RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-6746
Mailing Address - Country:US
Mailing Address - Phone:215-947-5373
Mailing Address - Fax:
Practice Address - Street 1:60 WELSH RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-6746
Practice Address - Country:US
Practice Address - Phone:215-947-5373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036270L282N00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0075815900001Medicaid
PA239648N4GMedicare PIN
PA68835Medicare UPIN