Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Jack Basil Dangelo Jr

Organization Physical Medicine & Rehabilitation Physician · NPI 1972236131

Jack Basil Dangelo Jr provides Physical Medicine & Rehabilitation Physician services 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