Provider Demographics
NPI:1447440615
Name:ANGELA ADAMS, MD, LLC
Entity type:Organization
Organization Name:ANGELA ADAMS, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-968-1825
Mailing Address - Street 1:117 KINDERKAMACK RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661-1941
Mailing Address - Country:US
Mailing Address - Phone:201-968-1825
Mailing Address - Fax:201-968-0110
Practice Address - Street 1:117 KINDERKAMACK RD
Practice Address - Street 2:SUITE 102
Practice Address - City:RIVER EDGE
Practice Address - State:NJ
Practice Address - Zip Code:07661-1941
Practice Address - Country:US
Practice Address - Phone:201-968-1825
Practice Address - Fax:201-968-0110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA25070804002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1225096423OtherINDIVIDUAL NPI