Provider Demographics
NPI:1245677756
Name:COLANGELO, MARIE C (NP-C)
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:C
Last Name:COLANGELO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:STIRLING
Mailing Address - State:NJ
Mailing Address - Zip Code:07980-1420
Mailing Address - Country:US
Mailing Address - Phone:908-705-7334
Mailing Address - Fax:
Practice Address - Street 1:249 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:STIRLING
Practice Address - State:NJ
Practice Address - Zip Code:07980-1420
Practice Address - Country:US
Practice Address - Phone:908-705-7334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-24
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00438100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily