Provider Demographics
NPI:1972799138
Name:ANGELITO O ARAGO,M D, P A
Entity type:Organization
Organization Name:ANGELITO O ARAGO,M D, P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANGELITO
Authorized Official - Middle Name:O
Authorized Official - Last Name:ARAGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-861-0720
Mailing Address - Street 1:6040 BOULEVARD EAST
Mailing Address - Street 2:L-7
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-3825
Mailing Address - Country:US
Mailing Address - Phone:201-861-0720
Mailing Address - Fax:
Practice Address - Street 1:6040 BOULEVARD EAST
Practice Address - Street 2:L-7
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-3825
Practice Address - Country:US
Practice Address - Phone:201-861-0720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02404200174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC55003Medicare UPIN