Provider Demographics
NPI:1609973700
Name:DEANGELO, FRANK J (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:J
Last Name:DEANGELO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 COOPER PLZ
Mailing Address - Street 2:SUITE 502
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-968-7433
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:COOPER UNIVERSITY TRAUMA PHYSICIANS
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-3014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0802222086S0127X
PAMD050836L2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2703810000OtherAMERIHEALTH/KEYSTONE/IBC
NJP00331097OtherRR MEDICARE
NJ00010769101OtherAMERICHOICE
42317OtherUNIVERISTY HEALTH PLAN
NJP3677724OtherOXFORD
NJ0100781Medicaid
NJ1847702OtherPA BS HIGHMARK
NJ60023740 & 60023738OtherHORIZON NJ HEALTH
NJ1222253/1222257OtherAETNA
NJP3723053OtherOXFORD
I26078Medicare UPIN
NJ1222253/1222257OtherAETNA
NJ0100781Medicaid