Provider Demographics
NPI:1124235890
Name:ANDALCIO, ANGELA A (NP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:A
Last Name:ANDALCIO
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13051 228TH ST
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-1742
Mailing Address - Country:US
Mailing Address - Phone:516-800-2279
Mailing Address - Fax:718-978-2917
Practice Address - Street 1:13051 228TH ST
Practice Address - Street 2:
Practice Address - City:LAURELTON
Practice Address - State:NY
Practice Address - Zip Code:11413-1742
Practice Address - Country:US
Practice Address - Phone:917-209-4606
Practice Address - Fax:718-978-2917
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334622207QA0505X, 207Q00000X
NYF334622-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily