Provider Demographics
NPI:1972865251
Name:DELLI GATTI, ANGELA (MSED, TSHH)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:DELLI GATTI
Suffix:
Gender:F
Credentials:MSED, TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16632 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-4008
Mailing Address - Country:US
Mailing Address - Phone:917-658-3759
Mailing Address - Fax:718-767-9183
Practice Address - Street 1:16632 22ND AVE
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-4008
Practice Address - Country:US
Practice Address - Phone:917-658-3759
Practice Address - Fax:718-767-9183
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist