Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 25MB08467300 | NJ |
Y | 207RH0002X | Hospice and Palliative Medicine | 25MB08467300 | NJ |
NPI | 1679770077 |
---|---|
Provider Name | Sara Nicole Pagliaro |
First Address | Marlton, NJ 08053 |
Second Address | Marlton, NJ 08053 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2007 |
Last Update Date | 26/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0203441 | (05) | NJ |