Provider Demographics
NPI:1679502744
Name:LINDEMUTH, ANGELA PALYS (DO)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:PALYS
Last Name:LINDEMUTH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:PALYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:12730 FORREST DR
Mailing Address - Street 2:
Mailing Address - City:EDINBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16412
Mailing Address - Country:US
Mailing Address - Phone:814-734-1541
Mailing Address - Fax:
Practice Address - Street 1:135 EAST 38TH ST
Practice Address - Street 2:DEPT OF VETERAN AFFAIRS MEDICAL CENTER
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16504
Practice Address - Country:US
Practice Address - Phone:814-860-2038
Practice Address - Fax:814-860-2110
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010033L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
G38997Medicare UPIN