Provider Demographics
NPI:1902975873
Name:ARCANGELO, VIRGINIA POOLE (PHD, FNP)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:POOLE
Last Name:ARCANGELO
Suffix:
Gender:F
Credentials:PHD, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 GROVE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-1224
Mailing Address - Country:US
Mailing Address - Phone:856-354-2211
Mailing Address - Fax:856-354-6181
Practice Address - Street 1:132 GROVE ST
Practice Address - Street 2:SUITE A
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-1224
Practice Address - Country:US
Practice Address - Phone:856-354-2211
Practice Address - Fax:856-354-6181
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN05391600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJS46822Medicare UPIN
NJ7968503Medicare ID - Type UnspecifiedMEDICARE