Provider Demographics
NPI:1235894650
Name:D'ANGELO, PAULA (RT(R))
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:D'ANGELO
Suffix:
Gender:F
Credentials:RT(R)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 WOODS RD
Mailing Address - Street 2:
Mailing Address - City:ABSECON
Mailing Address - State:NJ
Mailing Address - Zip Code:08201-2112
Mailing Address - Country:US
Mailing Address - Phone:215-416-1900
Mailing Address - Fax:
Practice Address - Street 1:107 WOODS RD
Practice Address - Street 2:
Practice Address - City:ABSECON
Practice Address - State:NJ
Practice Address - Zip Code:08201-2112
Practice Address - Country:US
Practice Address - Phone:215-416-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ6477532085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
400616OtherARRT