Provider Demographics
NPI:1891859781
Name:LAUCHANGCO, ANGELINA VENTURA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELINA
Middle Name:VENTURA
Last Name:LAUCHANGCO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANGELINA
Other - Middle Name:LAUCHANGCO
Other - Last Name:VELARDI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:450 E 20TH ST
Mailing Address - Street 2:8B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-8238
Mailing Address - Country:US
Mailing Address - Phone:212-228-6564
Mailing Address - Fax:212-995-5790
Practice Address - Street 1:155 E 47TH ST
Practice Address - Street 2:1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-2009
Practice Address - Country:US
Practice Address - Phone:646-840-0262
Practice Address - Fax:212-888-0249
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205550207Q00000X
NYMA61650207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5D9721Medicare ID - Type Unspecified
NJG12685Medicare UPIN