Provider Demographics
NPI:1659036903
Name:HANGEMANOLE, VASILIA IRENE (PA-C)
Entity Type:Individual
Prefix:
First Name:VASILIA
Middle Name:IRENE
Last Name:HANGEMANOLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 ROCK SPRING RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-2607
Mailing Address - Country:US
Mailing Address - Phone:443-640-4524
Mailing Address - Fax:443-567-5573
Practice Address - Street 1:7701 HARFORD RD
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-6403
Practice Address - Country:US
Practice Address - Phone:443-438-5147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant