Provider Demographics
NPI:1962852368
Name:DEBO, ANGELA ANTONIA (DO)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:ANTONIA
Last Name:DEBO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ANGELA
Other - Middle Name:ANTONIA
Other - Last Name:GENOESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:640 S. STATE STREET
Mailing Address - Street 2:MAIL CODE 3055
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-3530
Mailing Address - Country:US
Mailing Address - Phone:302-480-1688
Mailing Address - Fax:302-480-9807
Practice Address - Street 1:1074 S STATE ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-6925
Practice Address - Country:US
Practice Address - Phone:302-725-3200
Practice Address - Fax:302-725-3201
Is Sole Proprietor?:No
Enumeration Date:2016-06-16
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC2-0023981207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine