Provider Demographics
NPI:1730276437
Name:GUARIGLIA, GEORGE A (DO)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:A
Last Name:GUARIGLIA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 UNION VALLEY RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:HEWITT
Mailing Address - State:NJ
Mailing Address - Zip Code:07421-3024
Mailing Address - Country:US
Mailing Address - Phone:973-076-8535
Mailing Address - Fax:973-706-8536
Practice Address - Street 1:1900 UNION VALLEY RD
Practice Address - Street 2:SUITE 303
Practice Address - City:HEWITT
Practice Address - State:NJ
Practice Address - Zip Code:07421-3024
Practice Address - Country:US
Practice Address - Phone:973-076-8535
Practice Address - Fax:973-706-8536
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB66236207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00632474OtherRAILROAD MEDICARE
NJ028198BBCMedicare PIN
NJG96072Medicare UPIN