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Individual
MARK ANGELO
Active
Individual
MARK ANGELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MA76041
NJ
207R00000X
Internal Medicine Physician
Primary
MD072017L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009415
—
NJ
01
—
010005552
AMERICHOICE
NJ
01
—
1537742
AMERIHEALTH PPO/PABS
NJ
01
—
2222562000
AMERIHEALTH/KEYSTONE/IBC
NJ
01
—
3307356
AETNA
NJ
01
—
42473
UNIVERSITY HEALTH PLAN
NJ
01
—
5619054
CIGNA
NJ
01
—
60002302
HORIZON NJ HEALTH
NJ
01
—
P3130144
OXFORD
NJ
Enumeration date
10/12/2006
Last updated
02/28/2020
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