Provider Demographics
NPI:1811164635
Name:STRITT, ANGELA (MAC LAC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:STRITT
Suffix:
Gender:F
Credentials:MAC LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 TIOGA TER
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-1060
Mailing Address - Country:US
Mailing Address - Phone:518-210-6081
Mailing Address - Fax:
Practice Address - Street 1:323 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-1920
Practice Address - Country:US
Practice Address - Phone:518-210-6081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003709-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist