# GLEN C. CANGELOSI MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972645448
- **Authorized official:** MRS. DORIS FAYE L POLITO (INSURANCE CLERK BOOKKEEPER)
- **Authorized official phone:** (504) 282-7212

## Contact information

- **Practice address:** 4201 FRENCHMEN ST, NEW ORLEANS, LA 70122-3839
- **Practice address phone:** (504) 282-7212
- **Practice address fax:** (504) 282-7657
- **Mailing address:** 4201 FRENCHMEN ST, NEW ORLEANS, LA 70122-3839
- **Mailing address phone:** (504) 282-7212
- **Mailing address fax:** (504) 282-7657

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 016166 | LA | Yes |

## Other

- **Enumeration date:** 02/13/2007
- **Last updated:** 07/02/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1349259 | — | LA |