Basic Information
| Provider Information | |||||||||
| NPI: | 1255365458 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DE ANGELIS | ||||||||
| FirstName: | SYDNEY | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4535 DRESSLER RD NW | ||||||||
| Address2: | |||||||||
| City: | CANTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 447182545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3304934443 | ||||||||
| FaxNumber: | 3304938677 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 HOSPITAL RD | ||||||||
| Address2: | EMERGENCY DEPARTMENT | ||||||||
| City: | PATCHOGUE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117724870 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6316547236 | ||||||||
| FaxNumber: | 6312637491 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 12/13/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MD31788 | DC | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.