Healthcare Provider Details

I. General information

NPI: 1881605897
Provider Name (Legal Business Name): MARC R TOGLIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 11/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1098 W BALTIMORE PIKE SUITE 3404 RIDDLE HLTH CTR 3
MEDIA PA
19063-5139
US

IV. Provider business mailing address

1098 W BALTIMORE PIKE SUITE 3404 RIDDLE HLTH CTR 3
MEDIA PA
19063-5139
US

V. Phone/Fax

Practice location:
  • Phone: 610-627-4170
  • Fax: 610-627-4224
Mailing address:
  • Phone: 610-627-4170
  • Fax: 610-627-4224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberMD059676L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: