Provider Demographics
NPI:1497952022
Name:GIRONELLA, ANNA CARMELA SAGCAL (MD)
Entity Type:Individual
Prefix:
First Name:ANNA CARMELA
Middle Name:SAGCAL
Last Name:GIRONELLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNA CARMELA
Other - Middle Name:PONCE
Other - Last Name:SAGCAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:30 PROSPECT AVENUE
Mailing Address - Street 2:3 WFAN
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1915
Mailing Address - Country:US
Mailing Address - Phone:551-996-5306
Mailing Address - Fax:201-996-9815
Practice Address - Street 1:30 PROSPECT AVENUE
Practice Address - Street 2:3 WFAN
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1915
Practice Address - Country:US
Practice Address - Phone:551-996-5306
Practice Address - Fax:201-996-9815
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA103872002080P0216X
VA01012467312080P0216X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics