Provider Demographics
NPI:1326149634
Name:BIGELLI, ANGELO J (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANGELO
Middle Name:J
Last Name:BIGELLI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 SMITHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-4238
Mailing Address - Country:US
Mailing Address - Phone:401-353-6050
Mailing Address - Fax:401-353-1694
Practice Address - Street 1:464 SMITHFIELD RD
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-4238
Practice Address - Country:US
Practice Address - Phone:401-353-6050
Practice Address - Fax:401-353-1694
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDPM00201213ES0103X, 213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIRI201DPMMedicaid
RI48907319Medicare PIN
RI007002888Medicare PIN
RIRI201DPMMedicaid