Provider Demographics
NPI:1346269818
Name:JANNELLI, ANGELA FRANCES (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:FRANCES
Last Name:JANNELLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1609 WOODBOURNE RD
Mailing Address - Street 2:SUITE 302B
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19057-1500
Mailing Address - Country:US
Mailing Address - Phone:215-945-1313
Mailing Address - Fax:215-945-4277
Practice Address - Street 1:1609 WOODBOURNE RD
Practice Address - Street 2:SUITE 302B
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19057-1500
Practice Address - Country:US
Practice Address - Phone:215-945-1313
Practice Address - Fax:215-945-4277
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD015803E207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007990010002Medicaid
PA0023418000OtherPA BLUE CROSS/KEYSTONE
PA16898OtherAETNA
PA4248606OtherAETNA
PA0007990010002Medicaid
PA0023418000OtherPA BLUE CROSS/KEYSTONE