Provider Demographics
NPI:1013250075
Name:GAGLIOTI, JOSEPH GEORGE (DC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:GEORGE
Last Name:GAGLIOTI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3039 FOULK RD
Mailing Address - Street 2:
Mailing Address - City:GARNET VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19060-1701
Mailing Address - Country:US
Mailing Address - Phone:502-882-7172
Mailing Address - Fax:502-882-7151
Practice Address - Street 1:1400 PHILADELPHIA PIKE
Practice Address - Street 2:SUITE A4
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-1856
Practice Address - Country:US
Practice Address - Phone:302-778-9996
Practice Address - Fax:302-296-0996
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010706111N00000X
DEF1-0000857111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor