Individual ProviderFabian Alcaraz-AnguloInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address4300 Londonderry Rd, Harrisburg, PA 17109-5317(717) 231-8772PECOS EnrollmentBased on the most recent information from CMS, provider Fabian Alcaraz-Angulo is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 15 days ago.Profile DetailsProvider ID1144696576Provider TypeIndividualFull NameAlcaraz-Angulo, FabianCredentialMDGenderMaleSole ProprietorNoEnumeration Date8/20/2015Last Updated1/9/2021Contact InformationPractice LocationPractice Address4300 Londonderry Rd, Harrisburg, PA 17109-5317Phone(717) 231-8772Fax(717) 231-8435Mailing LocationMailing Address4300 Londonderry Rd, Harrisburg, PA 17109-5317Phone(717) 231-8772Fax(717) 231-8435Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseMD461677PennsylvaniaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID103320928DescriptionMedicaidIssuerUnlistedPennsylvania