Individual
JENNA ANGELO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
210 E 64TH ST FL 3, NEW YORK, NY 10065-7471
(724) 840-9149
Mailing address
210 E 64TH ST FL 3, NEW YORK, NY 10065-7471
(212) 434-6900
(212) 434-6950
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
722847
NY
207Q00000X
Family Medicine Physician
Primary
350444
NY
Other
Enumeration date
05/13/2016
Last updated
12/06/2022
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