Provider Demographics
NPI:1376884023
Name:SANGILLO, JOSEPH
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:SANGILLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17717 VAIL ST
Mailing Address - Street 2:APT 1316
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-6400
Mailing Address - Country:US
Mailing Address - Phone:469-471-1878
Mailing Address - Fax:
Practice Address - Street 1:17717 VAIL ST
Practice Address - Street 2:APT 1316
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-6400
Practice Address - Country:US
Practice Address - Phone:469-471-1878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic