Provider Demographics
NPI:1043377187
Name:ANGELORO, VINCENT CHARLES (CHIROPRACTOR)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:CHARLES
Last Name:ANGELORO
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 VETERANS HWY
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2948
Mailing Address - Country:US
Mailing Address - Phone:631-366-1611
Mailing Address - Fax:631-366-1743
Practice Address - Street 1:800 VETERANS HWY
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-2948
Practice Address - Country:US
Practice Address - Phone:631-366-1611
Practice Address - Fax:631-366-1743
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005157111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT93418Medicare UPIN
NYX42291Medicare ID - Type Unspecified