Provider Demographics
NPI:1609343029
Name:CORIGLIANO, LAUREN ANGELA (PA)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:ANGELA
Last Name:CORIGLIANO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 PHEASANT LN
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-4364
Mailing Address - Country:US
Mailing Address - Phone:908-768-1720
Mailing Address - Fax:
Practice Address - Street 1:511 PHEASANT LN
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-4364
Practice Address - Country:US
Practice Address - Phone:908-768-1720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-24
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00521200363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant