Provider Demographics
NPI:1336465350
Name:ANGULO, LOUIS (DC)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:ANGULO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 W 72ND ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2858
Mailing Address - Country:US
Mailing Address - Phone:212-769-9065
Mailing Address - Fax:212-769-3369
Practice Address - Street 1:230 W 72ND ST APT 2R
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2858
Practice Address - Country:US
Practice Address - Phone:212-769-9065
Practice Address - Fax:212-769-3369
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-15
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006356-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor