Provider Demographics
NPI:1063529352
Name:CARANGELO, ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:CARANGELO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:74 BATTERSON PARK RD STE 107
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2565
Mailing Address - Country:US
Mailing Address - Phone:860-549-8276
Mailing Address - Fax:860-674-8084
Practice Address - Street 1:201 N MOUNTAIN RD STE 302
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:CT
Practice Address - Zip Code:06062-1848
Practice Address - Country:US
Practice Address - Phone:860-223-8553
Practice Address - Fax:860-223-7273
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2021-06-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT030915207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001309154Medicaid
CTE84432Medicare UPIN
CT200000809Medicare PIN