Individual
JOHN ANGELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6 TECHNOLOGY DR STE 100, EAST SETAUKET, NY 11733-4079
(631) 689-6698
(631) 751-5548
Mailing address
6 TECHNOLOGY DR STE 100, EAST SETAUKET, NY 11733-4079
(631) 689-6698
(631) 751-5548
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
014323
NY
363AS0400X
Surgical Physician Assistant
Primary
014323
NY
Other
Enumeration date
11/17/2010
Last updated
05/17/2019
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