Provider Demographics
NPI:1891096228
Name:SINGER, ANGELA (PA-C)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:SINGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:GRILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:340 MONTAUK HWY STE 1
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4423
Mailing Address - Country:US
Mailing Address - Phone:631-422-9530
Mailing Address - Fax:631-376-1208
Practice Address - Street 1:340 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4437
Practice Address - Country:US
Practice Address - Phone:631-422-9530
Practice Address - Fax:631-376-1208
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014303-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant