Provider Demographics
NPI:1255365458
Name:DE ANGELIS, SYDNEY E (MD)
Entity type:Individual
Prefix:DR
First Name:SYDNEY
Middle Name:E
Last Name:DE ANGELIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4535 DRESSLER RD NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2545
Mailing Address - Country:US
Mailing Address - Phone:330-493-4443
Mailing Address - Fax:330-493-8677
Practice Address - Street 1:101 HOSPITAL RD
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-4870
Practice Address - Country:US
Practice Address - Phone:631-654-7236
Practice Address - Fax:631-263-7491
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD31788207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine