Provider Demographics
NPI:1497763692
Name:ANGELELLI, GAIL A (AUD)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:A
Last Name:ANGELELLI
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9003 LINCOLN DR W
Mailing Address - Street 2:SUITE B
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3205
Mailing Address - Country:US
Mailing Address - Phone:856-985-7770
Mailing Address - Fax:856-985-8533
Practice Address - Street 1:9003 LINCOLN DR W
Practice Address - Street 2:SUITE B
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3205
Practice Address - Country:US
Practice Address - Phone:856-985-7770
Practice Address - Fax:856-985-8533
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00024500231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8783004Medicaid
NJ8783004Medicaid