Healthcare Provider Details

I. General information

NPI: 1730276437
Provider Name (Legal Business Name): GEORGE A GUARIGLIA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 04/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 UNION VALLEY RD SUITE 303
HEWITT NJ
07421-3024
US

IV. Provider business mailing address

1900 UNION VALLEY RD SUITE 303
HEWITT NJ
07421-3024
US

V. Phone/Fax

Practice location:
  • Phone: 973-076-8535
  • Fax: 973-706-8536
Mailing address:
  • Phone: 973-076-8535
  • Fax: 973-706-8536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMB66236
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: