Provider Demographics
NPI:1790982577
Name:SUGAR, LISA D'ANGELO (APN)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:D'ANGELO
Last Name:SUGAR
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:TROLLEY SQUARE
Mailing Address - Street 2:SUITE 31-32A DE CHRONIC PAIN MANAGEMENT & DETOX CENTER
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-3719
Mailing Address - Country:US
Mailing Address - Phone:302-250-2166
Mailing Address - Fax:302-777-5483
Practice Address - Street 1:TROLLEY SQUARE
Practice Address - Street 2:SUITE 31-32A
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-3719
Practice Address - Country:US
Practice Address - Phone:302-250-2166
Practice Address - Fax:302-777-5483
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELB0000110363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care