Provider Demographics
NPI:1255399861
Name:DANGELO, STEVEN (PT)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:DANGELO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 NORTH SHERIDDAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-3651
Mailing Address - Country:US
Mailing Address - Phone:516-510-6172
Mailing Address - Fax:516-731-0430
Practice Address - Street 1:1040 HEMPSTEAD TURNPIKE
Practice Address - Street 2:SUITE LL3
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-2602
Practice Address - Country:US
Practice Address - Phone:516-502-4586
Practice Address - Fax:516-502-4587
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222391225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ26581Medicare ID - Type Unspecified