# ANGELIC HEALTH PRACTICE GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Angelic Primary Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497526065
- **Authorized official:** DAN MIKUS (CEO)
- **Authorized official phone:** (609) 822-7979

## Contact information

- **Practice address:** 8025 BLACK HORSE PIKE STE 501, PLEASANTVILLE, NJ 08232-2967
- **Practice address phone:** (609) 464-1135
- **Mailing address:** 8025 BLACK HORSE PIKE STE 501, PLEASANTVILLE, NJ 08232-2967
- **Mailing address phone:** (856) 812-8089

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/12/2024
- **Last updated:** 01/12/2024