Provider Demographics
NPI:1801898317
Name:MIGLIACCIO, JOSEPH D (DPM)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:D
Last Name:MIGLIACCIO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 MIDLAND AVE
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-1654
Mailing Address - Country:US
Mailing Address - Phone:973-772-6100
Mailing Address - Fax:973-546-5459
Practice Address - Street 1:357 MIDLAND AVE
Practice Address - Street 2:
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026-1654
Practice Address - Country:US
Practice Address - Phone:973-772-6100
Practice Address - Fax:973-546-5459
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD002283213E00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Not Answered213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6549608Medicaid
NJF15737OtherP.H.S. PROVIDER NUMBER
NJ1066593OtherHORIZON NJ HEALTH
NJP528859OtherOXFORD PROVIDER NUMBER
NJF15737OtherP.H.S. PROVIDER NUMBER
NJU56574Medicare UPIN