Provider Demographics
NPI:1376802405
Name:ANGELINO, KENNETH LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:LEE
Last Name:ANGELINO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:242 MERRICK RD STE 301
Mailing Address - Street 2:SOUTH NASSAU ONCOLOGY PRACTICE, PC
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-5254
Mailing Address - Country:US
Mailing Address - Phone:516-536-1455
Mailing Address - Fax:516-536-1598
Practice Address - Street 1:242 MERRICK RD STE 301
Practice Address - Street 2:SOUTH NASSAU ONCOLOGY PRACTICE, PC
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570
Practice Address - Country:US
Practice Address - Phone:516-536-1455
Practice Address - Fax:516-536-1598
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2018-08-21
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Provider Licenses
StateLicense IDTaxonomies
NY293255207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology