Provider Demographics
NPI:1588639348
Name:COGLIANI, ERMES (MD)
Entity type:Individual
Prefix:MR
First Name:ERMES
Middle Name:
Last Name:COGLIANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 STELTON RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-2665
Mailing Address - Country:US
Mailing Address - Phone:732-752-7755
Mailing Address - Fax:732-752-3705
Practice Address - Street 1:31 STELTON RD
Practice Address - Street 2:SUITE 4
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-2665
Practice Address - Country:US
Practice Address - Phone:732-752-7755
Practice Address - Fax:732-752-3705
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05768100207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO766017Medicare ID - Type Unspecified
NJF78154Medicare UPIN