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Individual

ANGELA T CAPO-GRANATA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
100 PORT WASHINGTON BLVD, ROSLYN, NY 11576-1353
(516) 629-2400
Mailing address
POB 1529, PORT WASHINGTON, NY 11050-1529
(516) 629-2076
(516) 629-2027

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
180012
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01245147
NY
Enumeration date
10/12/2006
Last updated
12/16/2008
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