Provider Demographics
NPI:1760971352
Name:ALBERT A ANGLADE M D P C
Entity Type:Organization
Organization Name:ALBERT A ANGLADE M D P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:ANGLADE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-564-8803
Mailing Address - Street 1:1515 CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-2613
Mailing Address - Country:US
Mailing Address - Phone:718-703-4968
Mailing Address - Fax:718-703-6720
Practice Address - Street 1:1515 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-2613
Practice Address - Country:US
Practice Address - Phone:718-703-4968
Practice Address - Fax:718-703-6720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-09
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209796207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty