Provider Demographics
NPI:1497870158
Name:LEAL, ANGEL M (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ANGEL
Middle Name:M
Last Name:LEAL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:HMP ORTHOPEDICS 333 EAST 56TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022
Mailing Address - Country:US
Mailing Address - Phone:212-308-2540
Mailing Address - Fax:212-308-2555
Practice Address - Street 1:333 E 56TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3758
Practice Address - Country:US
Practice Address - Phone:212-308-2540
Practice Address - Fax:212-308-2555
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY011149363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical