Basic Information
Provider Information
NPI: 1003148818
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ANGEL
FirstName: JULIETTE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D., M.P.H.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 13 QUAKER ROAD
Address2:  
City: PRINCETON JUNCTION
State: NJ
PostalCode: 085501615
CountryCode: US
TelephoneNumber: 6097995659
FaxNumber: 6097995659
Practice Location
Address1: 13 QUAKER ROAD
Address2:  
City: PRINCETON JUNCTION
State: NJ
PostalCode: 085501615
CountryCode: US
TelephoneNumber: 6097995659
FaxNumber: 6097995659
Other Information
ProviderEnumerationDate: 02/03/2010
LastUpdateDate: 02/03/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X148039-1NYN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RC0000X25MA05345900NJY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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