Provider Demographics
NPI:1790788313
Name:QUAGLIA, SILVIO (MD)
Entity Type:Individual
Prefix:
First Name:SILVIO
Middle Name:
Last Name:QUAGLIA
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 1:25 E WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1416
Mailing Address - Country:US
Mailing Address - Phone:973-379-5055
Mailing Address - Fax:973-379-5324
Practice Address - Street 1:25 E WILLOW ST
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1416
Practice Address - Country:US
Practice Address - Phone:973-379-5055
Practice Address - Fax:973-379-5324
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA56620207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
110071856OtherRAILROAD MEDICARE
NJ4987608Medicaid
0509263000OtherAMERIHEALTH
J1756OtherHORIZON
275711OtherUNITED HEALTHCARE
221976546OtherQUALCARE
0K4782OtherHEALTHNET
221976546OtherCHN
9948077008OtherCIGNA
4279015OtherAETNA
72K50OtherEMPIREHEALTH CHOICE
EP176OtherOXFORD
275711OtherUNITED HEALTHCARE
EP176OtherOXFORD