Provider Demographics
NPI:1326618927
Name:PIELAGO, ANGELLA MARIA BALDEVIA
Entity Type:Individual
Prefix:
First Name:ANGELLA MARIA
Middle Name:BALDEVIA
Last Name:PIELAGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BROADLYN CT
Mailing Address - Street 2:
Mailing Address - City:BARDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:10954-1401
Mailing Address - Country:US
Mailing Address - Phone:845-729-3535
Mailing Address - Fax:
Practice Address - Street 1:10 BROADLYN CT
Practice Address - Street 2:
Practice Address - City:BARDONIA
Practice Address - State:NY
Practice Address - Zip Code:10954-1401
Practice Address - Country:US
Practice Address - Phone:845-729-3535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics