Provider Demographics
NPI:1508884719
Name:BRIGLIA, PHILIP THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:THOMAS
Last Name:BRIGLIA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 NEW RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1371
Mailing Address - Country:US
Mailing Address - Phone:609-653-6200
Mailing Address - Fax:609-926-8175
Practice Address - Street 1:210 NEW RD
Practice Address - Street 2:SUITE 6
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1371
Practice Address - Country:US
Practice Address - Phone:609-653-6200
Practice Address - Fax:609-926-8175
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC02630111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ445747Medicare ID - Type Unspecified