Provider Demographics
NPI:1770876401
Name:ANGEL Q. RAPOSAS, MD, PC
Entity type:Organization
Organization Name:ANGEL Q. RAPOSAS, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:QUIANO
Authorized Official - Last Name:RAPOSAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-693-1024
Mailing Address - Street 1:3552 WOODSIDE RD
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-5258
Mailing Address - Country:US
Mailing Address - Phone:814-693-1024
Mailing Address - Fax:
Practice Address - Street 1:501 HOWARD AVE
Practice Address - Street 2:SUITE D101
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4810
Practice Address - Country:US
Practice Address - Phone:814-941-3005
Practice Address - Fax:814-941-3445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD059783L207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
040084K16OtherMEDICARE UNSPECIFIED
PA0018116200001Medicaid
PAH21772Medicare UPIN