Provider Demographics
NPI:1134400641
Name:RENATA ANGELINI PC
Entity type:Organization
Organization Name:RENATA ANGELINI PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RENATA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGELINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-363-8589
Mailing Address - Street 1:901 N PENN ST
Mailing Address - Street 2:APT R407
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19123-3132
Mailing Address - Country:US
Mailing Address - Phone:610-524-1552
Mailing Address - Fax:
Practice Address - Street 1:901 N PENN ST
Practice Address - Street 2:APT R407
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19123-3132
Practice Address - Country:US
Practice Address - Phone:610-524-1552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-30
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4381182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty