Provider Demographics
NPI:1679780191
Name:ANGELO, RENEE (AUD)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:ANGELO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 SOUTHWOOD DRIVE
Mailing Address - Street 2:DARTMOUTH HITCHCOCK - AUDIOLOGY
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063
Mailing Address - Country:US
Mailing Address - Phone:603-577-4141
Mailing Address - Fax:
Practice Address - Street 1:2300 SOUTHWOOD DRIVE
Practice Address - Street 2:DARTMOUTH HITCHCOCK - AUDIOLOGY
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063
Practice Address - Country:US
Practice Address - Phone:603-577-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000996-1231H00000X
NHA12231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400001635Medicare PIN