Provider Demographics
NPI:1811923220
Name:HITSOUS, ANGELA ELAINE (P T)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:ELAINE
Last Name:HITSOUS
Suffix:
Gender:F
Credentials:P T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 HAMPTON CT
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-3021
Mailing Address - Country:US
Mailing Address - Phone:516-944-5665
Mailing Address - Fax:516-767-7496
Practice Address - Street 1:444 LAKEVILLE RD
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1165
Practice Address - Country:US
Practice Address - Phone:516-775-7960
Practice Address - Fax:516-775-1483
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004454-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY004454-1OtherPHYSICAL THERAPIST
NY004454-1OtherPHYSICAL THERAPIST