Provider Demographics
NPI:1922437268
Name:TARANGELO, PAUL (PA)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:TARANGELO
Suffix:
Gender:M
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:5838 SIX FORKS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-3893
Mailing Address - Country:US
Mailing Address - Phone:919-785-3400
Mailing Address - Fax:919-783-7778
Practice Address - Street 1:5838 SIX FORKS RD STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-3893
Practice Address - Country:US
Practice Address - Phone:919-785-3400
Practice Address - Fax:919-783-7778
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-06601363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant