Provider Demographics
NPI:1043548266
Name:AMICANGIOLI, CINDY DEBRA (RN)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:DEBRA
Last Name:AMICANGIOLI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 PINEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-4505
Mailing Address - Country:US
Mailing Address - Phone:781-283-9162
Mailing Address - Fax:
Practice Address - Street 1:17 PINEWOOD RD
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482-4505
Practice Address - Country:US
Practice Address - Phone:781-283-9162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-29
Last Update Date:2009-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2258810163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse