Provider Demographics
NPI:1891714424
Name:ALBERO, ANGELA (PA)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:ALBERO
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 LAKESHORE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-4205
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:455 LAKESHORE PARKWAY
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-4205
Practice Address - Country:US
Practice Address - Phone:803-909-6363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-05870363A00000X, 363A00000X
SC2472363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1891714424Medicaid
SC2376PAMedicaid
NCNCQ057CMedicare PIN
NCNCQ057EMedicare PIN
NCNCQ057AMedicare PIN
NCNCQ057BMedicare PIN
NCNCQ057DMedicare PIN
SC2376PAMedicaid