Provider Demographics
NPI:1912495060
Name:PHIPPS, ANGELA
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:
Last Name:PHIPPS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 RTE 4W
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-8889
Mailing Address - Country:US
Mailing Address - Phone:973-486-4883
Mailing Address - Fax:
Practice Address - Street 1:275 RTE 4W
Practice Address - Street 2:SUITE 135
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2403
Practice Address - Country:US
Practice Address - Phone:204-487-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-24
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ32WG02083200224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist