Provider Demographics
NPI:1083096754
Name:GAGLIONE, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GAGLIONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:LOREN
Other - Last Name:GAGLIONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:505 PERRY RD
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:NJ
Mailing Address - Zip Code:08270-9633
Mailing Address - Country:US
Mailing Address - Phone:609-425-3740
Mailing Address - Fax:
Practice Address - Street 1:3001 E EVESHAM RD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-9547
Practice Address - Country:US
Practice Address - Phone:856-751-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00698000225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist