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General NPI Number Information
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NPI Number | 1376583492
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Entity Type | Individual
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Provider Name | PAUL JOSEPH GAGLIO SR. MD
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | DOCTORS OFFICE CENTER 90 BERGEN STREET SUITE 4500
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City | NEWARK
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State | NJ
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Zip | 07631
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Country | US
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Telephone | 973-972-5252
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Fax | 212-305-4343
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Provider Business Mailing Address
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Address Line | 555 CUMBERLAND ST PH 14
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-4705
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Country | US
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Telephone | 917-575-6509
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 179243
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RI0008X
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Taxonomy Name | Hepatology Physician
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License Number | 1792431
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207RT0003X
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Taxonomy Name | Transplant Hepatology Physician
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License Number | 179243-1
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207RT0003X
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Taxonomy Name | Transplant Hepatology Physician
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License Number | 25MA05421700
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License Number State | NJ
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