Provider Demographics
NPI:1093502494
Name:CANGIALOSI, ALLISON (NP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:CANGIALOSI
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 CENTER BLVD APT 3917
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11109-5985
Mailing Address - Country:US
Mailing Address - Phone:631-885-1264
Mailing Address - Fax:
Practice Address - Street 1:4545 CENTER BLVD APT 3917
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11109-5985
Practice Address - Country:US
Practice Address - Phone:631-885-1264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY312119363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health