Provider Demographics
NPI:1871780122
Name:LUGO STEIDEL, ANGEL G (PHD)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:G
Last Name:LUGO STEIDEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:KELLER ARMY COMMUNITY HOSPITAL
Mailing Address - Street 2:COMMUNITY MENTAL HEALTH SERVICES
Mailing Address - City:WEST POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10996
Mailing Address - Country:US
Mailing Address - Phone:845-938-3441
Mailing Address - Fax:845-938-5770
Practice Address - Street 1:KELLER ARMY COMMUNITY HOSPITAL
Practice Address - Street 2:COMMUNITY MENTAL HEALTH SERVICES
Practice Address - City:WEST POINT
Practice Address - State:NY
Practice Address - Zip Code:10996
Practice Address - Country:US
Practice Address - Phone:845-938-3441
Practice Address - Fax:845-938-5770
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017122-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical