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Angeleah Ribao Dadivas

Family Medicine

Allopathic & Osteopathic Physicians

740 High St Ste 4001, Williamsport, PA 17701-3111

PECOS Enrollment

This provider is enrolled in PECOS as ANGELEAH DADIVAS.

Based on the most recent information from CMS, provider Angeleah Ribao Dadivas is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1588286587
Provider Type
Individual
Full Name
Dadivas, Angeleah Ribao
Credential
DO

Gender
Female
Sole Proprietor
No
Enumeration Date
5/12/2020
Last Updated
11/9/2023

Contact Information

Practice Location

740 High St Ste 4001, Williamsport, PA 17701-3111

(570) 321-2340

Unlisted Fax

Mailing Location

3600 Forbes Ave Ste 140, Pittsburgh, PA 15213-3410

(412) 647-6426

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License OS023083 Pennsylvania
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Angeleah Ribao Dadivas

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Haussmann, Andrew Nelson

Anderson, Elizabeth

Mullarkey, Donna

Parrish, Thomas

Brown, Jenna Ann

Susquehanna Physician Services

Skipton, Kate E

Susquehanna Physician Services

Susquehanna Physician Services

Heilmann, Timothy