Provider Demographics
NPI:1295824308
Name:ANGELELLA, FRANCIS M (PSYD)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:M
Last Name:ANGELELLA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1277 WYOMING AVENUE
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:PA
Mailing Address - Zip Code:18643-1435
Mailing Address - Country:US
Mailing Address - Phone:570-654-8000
Mailing Address - Fax:570-654-8002
Practice Address - Street 1:1277 WYOMING AVENUE
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:PA
Practice Address - Zip Code:18643-1435
Practice Address - Country:US
Practice Address - Phone:570-654-8000
Practice Address - Fax:570-654-8002
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016003103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100779Medicare ID - Type UnspecifiedPROVIDER NUMBER