Provider Demographics
NPI:1407147457
Name:ANGIOLELLI, ROCCO
Entity Type:Individual
Prefix:
First Name:ROCCO
Middle Name:
Last Name:ANGIOLELLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 DINSMORE PL
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-2006
Mailing Address - Country:US
Mailing Address - Phone:646-459-3615
Mailing Address - Fax:646-459-3990
Practice Address - Street 1:590 AVENUE OF THE AMERICAS
Practice Address - Street 2:SUITE 633
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2019
Practice Address - Country:US
Practice Address - Phone:646-459-3615
Practice Address - Fax:646-459-3990
Is Sole Proprietor?:No
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY27222183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist