Provider Demographics
NPI:1346388279
Name:DE ANGELIS, MICHAEL JOSEPH (PT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:DE ANGELIS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:2210 HIGHWAY 9W
Mailing Address - Street 2:
Mailing Address - City:SAUGERTIES
Mailing Address - State:NY
Mailing Address - Zip Code:12477-4773
Mailing Address - Country:US
Mailing Address - Phone:845-336-5537
Mailing Address - Fax:845-247-2353
Practice Address - Street 1:3165 HIGHWAY 9W
Practice Address - Street 2:
Practice Address - City:SAUGERTIES
Practice Address - State:NY
Practice Address - Zip Code:12477-5220
Practice Address - Country:US
Practice Address - Phone:845-247-2351
Practice Address - Fax:845-247-2353
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0165832251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic