Provider Demographics
NPI:1518096510
Name:MARGALLO, EVANGELINE COBIN (MD)
Entity Type:Individual
Prefix:DR
First Name:EVANGELINE
Middle Name:COBIN
Last Name:MARGALLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 KRESSON RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2604
Mailing Address - Country:US
Mailing Address - Phone:856-795-3320
Mailing Address - Fax:856-795-1213
Practice Address - Street 1:710 KRESSON RD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2604
Practice Address - Country:US
Practice Address - Phone:856-795-3320
Practice Address - Fax:856-795-1213
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05665900208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics