Provider Demographics
NPI:1578600706
Name:E. A. ANGELINI OD LTD
Entity Type:Organization
Organization Name:E. A. ANGELINI OD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ETTORE
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:ANGELINI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:775-322-4061
Mailing Address - Street 1:350 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4519
Mailing Address - Country:US
Mailing Address - Phone:775-322-4061
Mailing Address - Fax:775-322-6603
Practice Address - Street 1:350 W 6TH ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4519
Practice Address - Country:US
Practice Address - Phone:775-322-4061
Practice Address - Fax:775-322-6603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV148152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV5633950001Medicare NSC