Provider Demographics
NPI:1922021187
Name:MORALES, ANGELO L (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELO
Middle Name:L
Last Name:MORALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:50 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:W SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-3901
Mailing Address - Country:US
Mailing Address - Phone:413-739-4842
Mailing Address - Fax:413-746-1125
Practice Address - Street 1:300 STAFFORD ST
Practice Address - Street 2:SUITE 300
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-3581
Practice Address - Country:US
Practice Address - Phone:413-734-7758
Practice Address - Fax:413-734-4007
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA44173208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics