Healthcare Provider Details

I. General information

NPI: 1962375576
Provider Name (Legal Business Name): MR. WILLIAM JAMES GAGLIANO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2025
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19333 W NORTH AVE
BROOKFIELD WI
53045-4132
US

IV. Provider business mailing address

2479 N 88TH ST
WAUWATOSA WI
53226-1955
US

V. Phone/Fax

Practice location:
  • Phone: 262-785-2220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number24967630
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: