Provider Demographics
NPI:1760211684
Name:AIKENS, DANGELO
Entity type:Individual
Prefix:
First Name:DANGELO
Middle Name:
Last Name:AIKENS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10120 WESTRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241-6617
Mailing Address - Country:US
Mailing Address - Phone:216-758-0252
Mailing Address - Fax:
Practice Address - Street 1:113 UNION ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-4541
Practice Address - Country:US
Practice Address - Phone:216-272-4283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company
No343800000XTransportation ServicesSecured Medical Transport (VAN)