Healthcare Provider Details

I. General information

NPI: 1134158108
Provider Name (Legal Business Name): ROBERT A. STAGLIANO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 ATLANTIC AVE
COLLINGSWOOD NJ
08108-3042
US

IV. Provider business mailing address

600 ATLANTIC AVE
COLLINGSWOOD NJ
08108-3042
US

V. Phone/Fax

Practice location:
  • Phone: 856-854-1050
  • Fax:
Mailing address:
  • Phone: 856-854-1050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: