Pangallo, Cynthia A

Pangallo, Cynthia A is an individual health care provider with primary practice located at 888 Thackeray Trl Ste 103 , Oconomowoc WI 53066-4342. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular Surgery, Allopathic & Osteopathic Physicians / Colon & Rectal Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is her primary health care specialty. Pangallo, Cynthia A can be contacted via phone (262) 567-1499.

Contact Information

Primary practice address
888 Thackeray Trl Ste 103 Oconomowoc WI 53066-4342
Fax: (262) 567-4502
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 32603 Wisconsin
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X 32603 Wisconsin
Allopathic & Osteopathic Physicians / Surgery 208600000X 32603 Wisconsin

Profile Details

NPI number 1710946132
LBN Legal business name Pangallo, Cynthia A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2006
Last updated Mar 17th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710946132 NPPES
Wisconsin MEDICAID 317237300

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