Provider Demographics
NPI:1669908083
Name:KALINOWSKI, ANGELA (MD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:KALINOWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 NORTHERN BLVD STE K
Mailing Address - Street 2:
Mailing Address - City:SOUTH ABINGTON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18411-8799
Mailing Address - Country:US
Mailing Address - Phone:570-586-4141
Mailing Address - Fax:570-586-6722
Practice Address - Street 1:790 NORTHERN BLVD STE K
Practice Address - Street 2:
Practice Address - City:SOUTH ABINGTON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18411-8799
Practice Address - Country:US
Practice Address - Phone:570-586-4141
Practice Address - Fax:570-586-6722
Is Sole Proprietor?:No
Enumeration Date:2017-05-04
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT213086207Q00000X
PAMD468682207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine