Provider Demographics
NPI:1528067832
Name:ANGIOLETTI, LOUIS V JR (MD)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:V
Last Name:ANGIOLETTI
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-3112
Mailing Address - Country:US
Mailing Address - Phone:973-987-3380
Mailing Address - Fax:866-806-3675
Practice Address - Street 1:1086 TEANECK ROAD
Practice Address - Street 2:SUITE 2A
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666
Practice Address - Country:US
Practice Address - Phone:201-871-3414
Practice Address - Fax:201-871-4830
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY105144-1207W00000X
NJ25MA10886200207WX0107X
NJ25MA02310800207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ518496OtherAETNA INSURANCE CO.
NJNS416OtherOXFORD HEALTH PLANS
NY00305091Medicaid
NJOC5520OtherHEALTHNET INSURANCE
NY525135OtherAETNA INSURANCE COMPANY
NJ1369407Medicaid
NY56618200Medicare PIN
NY525135OtherAETNA INSURANCE COMPANY
NJNS416OtherOXFORD HEALTH PLANS