Provider Demographics
NPI:1679770077
Name:PAGLIARO, SARA NICOLE (DO)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:NICOLE
Last Name:PAGLIARO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 EVES DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053
Mailing Address - Country:US
Mailing Address - Phone:856-596-1600
Mailing Address - Fax:856-552-3268
Practice Address - Street 1:5 EVES DRIVE
Practice Address - Street 2:SUITE 300
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053
Practice Address - Country:US
Practice Address - Phone:856-596-1600
Practice Address - Fax:856-552-3268
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08467300207RH0002X, 208M00000X, 207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0203441Medicaid
NJ160827ASDMedicare PIN