Provider Demographics
NPI:1932699204
Name:DIANGELO, CONSTANCE R (MD)
Entity Type:Individual
Prefix:DR
First Name:CONSTANCE
Middle Name:R
Last Name:DIANGELO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3808 MILITARY RD NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2704
Mailing Address - Country:US
Mailing Address - Phone:202-903-7998
Mailing Address - Fax:
Practice Address - Street 1:3808 MILITARY RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2704
Practice Address - Country:US
Practice Address - Phone:202-903-7998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-13
Last Update Date:2018-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD32443207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology