Active NPI
Georgia Marie Angelo, FNP-BC
- Family Nurse Practitioner
- Staten Island, NY
National Provider Identifier
1104331701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F341356
- Practice address
- 355 Bard Ave
Staten Island, NY 10310-1664 - Phone
- (718) 818-1234
- NPI assigned
- Dec 5, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F341356 | NY | Primary |
Addresses
Primary practice location
355 Bard Ave
Staten Island, NY 10310-1664
Mailing address
355 Bard Ave
Staten Island, NY 10310-1664
Phone (718) 818-1117
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F341356 | NY | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552348800000",
"number": "1104331701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 BARD AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103101664",
"telephone_number": "718-818-1117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 BARD AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103101664",
"telephone_number": "718-818-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANGELO",
"first_name": "GEORGIA",
"middle_name": "MARIE",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-05",
"last_updated": "2019-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F341356",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.