Provider Demographics
NPI:1841249562
Name:ANGELS, ROBERT R (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:R
Last Name:ANGELS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:211 ESSEX ST
Mailing Address - Street 2:SUITE102
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-3231
Mailing Address - Country:US
Mailing Address - Phone:201-646-1200
Mailing Address - Fax:201-636-1206
Practice Address - Street 1:360 ESSEX ST STE 303
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-8566
Practice Address - Country:US
Practice Address - Phone:551-996-8100
Practice Address - Fax:551-996-4140
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY54793712084N0600X
NJ25MA067768002084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0085014Medicaid
NYG49704Medicare UPIN
NJG79704Medicare UPIN
NJ017596Medicare ID - Type Unspecified