Individual
LEE M ANGIOLETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1255 BROAD ST STE 104, BLOOMFIELD, NJ 07003-3061
(973) 707-5632
(973) 707-7349
Mailing address
1 CORPORATE DR, WAYNE, NJ 07470-3112
(973) 987-3380
(973) 987-3379
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
183273-1
NY
207W00000X
Ophthalmology Physician
Primary
25MA06097700
NJ
207WX0107X
Retina Specialist (Ophthalmology) Physician
25MA06097700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01471109
—
NY
01
—
497580
AETNA INSURANCE CO.
NY
01
—
497587
AETNA INSURANCE CO.
NJ
05
—
6234003
—
NJ
01
—
OC5519
HEALTHNET INSURANCE CO.
NY
01
—
P377500
OXFORD HEALTH PLANS
NJ
Enumeration date
07/19/2005
Last updated
03/23/2022
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