Basic Information
Provider Information
NPI: 1518223528
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: INGRAM
FirstName: ANGELA
MiddleName: R
NamePrefix:  
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Credential: MD
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Mailing Information
Address1: 2 CATHARINE STREET, P.O. BOX 550
Address2: EAST MANHATTAN ANESTHESIC PARTNERS, LLC
City: POUGHKEEPSIE
State: NY
PostalCode: 12602
CountryCode: US
TelephoneNumber: 8668688415
FaxNumber: 8457902675
Practice Location
Address1: 310 E. 14TH STREET
Address2: NY EYE & EAR INFIRMARY
City: NEW YORK
State: NY
PostalCode: 10003
CountryCode: US
TelephoneNumber: 2129794000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/03/2012
LastUpdateDate: 01/29/2019
NPIDeactivationReasonCode:  
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ProviderGenderCode: F
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IsSoleProprietor: N
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X287755-1NYY Allopathic & Osteopathic PhysiciansAnesthesiology 
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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