Provider Demographics
NPI:1629406871
Name:ANGIULI, DOMENICA ANGELA (AGNP)
Entity Type:Individual
Prefix:MS
First Name:DOMENICA
Middle Name:ANGELA
Last Name:ANGIULI
Suffix:
Gender:F
Credentials:AGNP
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Mailing Address - Street 1:163 FORT EVANS RD NE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-4420
Mailing Address - Country:US
Mailing Address - Phone:703-443-2000
Mailing Address - Fax:703-433-2033
Practice Address - Street 1:11835 QUEENS BLVD STE 400
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-7211
Practice Address - Country:US
Practice Address - Phone:646-722-7610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-25
Last Update Date:2023-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0024171728363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health