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Jack Basil Dangelo Jr

Physical Medicine & Rehabilitation Physician in Staten Island, NY · enumerated 2022 · authorized official Jack D'Angelo, President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1972236131

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Registry record

Entity type Organization (Type 2)
Legal business name Jack Basil Dangelo Jr
Practice address 191 Bradley Ave, Staten Island, NY, 10314
Phone (917) 748-8341
Fax (917) 970-9703
Enumeration date Jul 6, 2022
Last updated in NPPES Jul 6, 2022

Taxonomy & classification

208100000X Physical Medicine & Rehabilitation Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Jack D'Angelo
Title President
Phone (917) 748-8341

Other identifiers

Identifier Type State Issuer
01484220 Medicaid NY -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2022-07-06. Verify at npiregistry.cms.hhs.gov.
Where is Jack Basil Dangelo Jr located?
The practice location on file with NPPES is in Staten Island, NY.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2022-07-06.