Provider Demographics
NPI:1447225719
Name:GAGLIARDI, NATALE JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:NATALE
Middle Name:JOSEPH
Last Name:GAGLIARDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5101 PENFIELD RD W
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2218
Mailing Address - Country:US
Mailing Address - Phone:410-707-7547
Mailing Address - Fax:410-992-6804
Practice Address - Street 1:2528 MOUNTAIN RD
Practice Address - Street 2:#204
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-2300
Practice Address - Country:US
Practice Address - Phone:410-255-4475
Practice Address - Fax:410-255-6277
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD25774207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD15740-1900Medicaid
MD15740-1900Medicaid