Provider Demographics
NPI:1134980915
Name:CIFUNI, ANGELA ROSE (CRPA)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:ROSE
Last Name:CIFUNI
Suffix:
Gender:F
Credentials:CRPA
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:ROSE
Other - Last Name:CIFUNI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRPA
Mailing Address - Street 1:706 EXECUTIVE BLVD
Mailing Address - Street 2:
Mailing Address - City:VALLEY COTTAGE
Mailing Address - State:NY
Mailing Address - Zip Code:10989-2038
Mailing Address - Country:US
Mailing Address - Phone:453-623-9048
Mailing Address - Fax:
Practice Address - Street 1:706 EXECUTIVE BLVD
Practice Address - Street 2:
Practice Address - City:VALLEY COTTAGE
Practice Address - State:NY
Practice Address - Zip Code:10989-2038
Practice Address - Country:US
Practice Address - Phone:453-623-9048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175T00000X
NY175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist