Healthcare Provider Details

I. General information

NPI: 1386649879
Provider Name (Legal Business Name): JOSEPH PAUL YAMPAGLIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 04/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 W SHERMAN AVE
VINELAND NJ
08360-6912
US

IV. Provider business mailing address

PO BOX 8500-4066
PHILADELPHIA PA
19178-0001
US

V. Phone/Fax

Practice location:
  • Phone: 302-709-4497
  • Fax: 302-733-0854
Mailing address:
  • Phone: 302-709-4497
  • Fax: 302-733-0854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA04829600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: