Provider Demographics
NPI:1639064462
Name:MACIEL, JOSE ANGEL (RN)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:ANGEL
Last Name:MACIEL
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 S 42ND ST APT 2F
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4443
Mailing Address - Country:US
Mailing Address - Phone:509-961-3223
Mailing Address - Fax:
Practice Address - Street 1:519 S 42ND ST APT 2F
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4443
Practice Address - Country:US
Practice Address - Phone:509-961-3223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN730033163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine