Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack Basil Dangelo Jr

Organization Physical Medicine & Rehabilitation Physician · NPI 1972236131

Jack Basil Dangelo Jr is a Physical Medicine & Rehabilitation Physician in Staten Island, New York. Registered with an NPI since 2022.

In the registry since
2022

Practice location Address checks out

191 Bradley Ave
Staten Island, NY 10314-5166
Phone: (917) 748-8341
Fax: (917) 970-9703
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X

Record details

NPI number1972236131
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jack D'Angelo — President · (917) 748-8341
NPI enumeratedJuly 6, 2022
Last updated in NPPESJuly 6, 2022
Certification dateJuly 6, 2022
Mailing address3 Carpender Rd, New Brunswick, NJ 08901-1501

Other providers in Staten Island