Provider Demographics
NPI:1811991458
Name:ANGELO, SHARON (DO)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:
Last Name:ANGELO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 AVENUE AT THE CMN
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4569
Mailing Address - Country:US
Mailing Address - Phone:732-380-9000
Mailing Address - Fax:732-380-9232
Practice Address - Street 1:180 AVENUE AT THE CMN
Practice Address - Street 2:SUITE 6
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4569
Practice Address - Country:US
Practice Address - Phone:732-380-9000
Practice Address - Fax:732-380-9232
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB56774207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP3590285OtherOXFORD
NJJ34726OtherHEALTH NET
NJ0492485002OtherAMERIHEALTH
NJ110095494OtherRAILROAD MEDICARE
NJ0492473OtherAETNA
NJ754781OtherWELLCHOICE
NJ223326706OtherHORIZON
NJE76353Medicare UPIN
NJ223326706OtherHORIZON