Provider Demographics
NPI:1922047877
Name:NOTARANGELO, VINCENT (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
Last Name:NOTARANGELO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1619 POT SPRING RD
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-5911
Mailing Address - Country:US
Mailing Address - Phone:410-296-4751
Mailing Address - Fax:
Practice Address - Street 1:3001 S HANOVER ST
Practice Address - Street 2:GRUEHN BUILDING, SUITE 100
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21225-1233
Practice Address - Country:US
Practice Address - Phone:410-354-1065
Practice Address - Fax:410-354-2805
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD019295207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD200158OtherMARYLAND VISION
MD282290OtherBS VA
MD79670OtherPHN
MD1390396OtherCIGNA PPO
MD333011OtherADVANTICA
MD122638OtherAETNA
MD21786OtherALLIANCE
MD21786OtherOPTIMUM CHOICE
MD3726OtherELDERHEALTH
MD0001-R785OtherBLUE CHOICE
MD04445OtherAMERICAID
MD5691OtherBLUE CROSS
MD233OtherBALTIMORE CITY VISION
MDB70166Medicare UPIN
MD5691Medicare PIN