Provider Demographics
NPI:1104971498
Name:D'ORSI, ANGELA V (MD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:V
Last Name:D'ORSI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-0457
Mailing Address - Country:US
Mailing Address - Phone:484-476-3391
Mailing Address - Fax:866-848-9001
Practice Address - Street 1:100 E LANCASTER AVE STE B7
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:484-476-3391
Practice Address - Fax:866-848-9001
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD045121L208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0076259170002Medicaid
PA1159444OtherKEYSTONE MERCY HEALTH
PA0774667000OtherKEYSTONE HEALTH PLAN EAST
PA0934614005OtherCIGNA
PA2512775OtherAETNA
PA1265673OtherUNITED HEALTHCARE
PA250012002OtherRR MEDICARE
PA041427Medicare ID - Type Unspecified
PA2512775OtherAETNA