| Doctor Name: | DR. JOHN DEANGELIS |
| NPI Number: | 1255625745 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 273115 |
| Business Practice Address: | 601 Elmwood Ave Box 655 Rochester, NY - 146420001 |
| Business Phone Number: | 5854632940 |
| Business Fax Number: | |
| Mailing Address: | 601 Elmwood Ave Box 655, ROCHESTER |
| State: | NY |
| Postal Code: | 146420001 |
| Phone Number: | 5854632940 |
| Fax Number: | |
| NPI Enumeration Date: | 06/02/2011 |
| NPI Last Update Date: | 07/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 273115 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |