Jack Basil Dangelo Jr

LBN: Jack Basil Dangelo Jr
Jack Basil Dangelo Jr is an health care organization with primary practice located at 191 Bradley Ave , Staten Island NY 10314-5166. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as the primary health care specialty. Jack Basil Dangelo Jr can be contacted via phone (917) 748-8341, or through D'Angelo, Jack via phone (917) 748-8341.

Contact Information

Primary practice address
191 Bradley Ave Staten Island NY 10314-5166
Phone: (917) 748-8341
Fax: (917) 970-9703
Website:
Map and Directions
Authorized official contact:
Name: D'Angelo, Jack Doctor of Medicine (MD)
Phone: (917) 748-8341

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X

Profile Details

NPI number 1972236131
LBN Legal business name Jack Basil Dangelo Jr
DBA Doing business as
Authorized official D'Angelo, Jack Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 6th, 2022
Last updated Jul 6th, 2022 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972236131 NPPES
New York MEDICAID 01484220

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