Provider Demographics
NPI:1174833040
Name:VINCENT M. NOTARANGELO, MD, PA
Entity Type:Organization
Organization Name:VINCENT M. NOTARANGELO, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER/M.D.
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:M
Authorized Official - Last Name:NOTARANGELO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-354-1061
Mailing Address - Street 1:3001 S. HANOVER STREET
Mailing Address - Street 2:HARBOR HOSPITAL, GRUEHN BUILDING, SUITE 100
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21225
Mailing Address - Country:US
Mailing Address - Phone:410-354-1061
Mailing Address - Fax:410-354-2805
Practice Address - Street 1:3001 S. HANOVER STREET, SUITE 100
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21225
Practice Address - Country:US
Practice Address - Phone:410-354-1061
Practice Address - Fax:410-354-2805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-13
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD19295207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty