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General NPI Number Information
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NPI Number | 1235339433
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Entity Type | Individual
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Provider Name | ANTHONY JAMES NIGLIAZZO M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 10/29/2019
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Provider Practice Location Address
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Address Line | 305 ESTILL ST
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City | BEREA
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State | KY
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Zip | 40403-1742
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Country | US
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Telephone | 859-986-8418
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Fax |
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Provider Business Mailing Address
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Address Line | 106 HANOVER DR
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City | LONDON
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State | KY
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Zip | 40741-9775
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Country | US
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Telephone | 260-301-4062
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 4301090768
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License Number State | MI
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