Provider Demographics
NPI:1982953592
Name:MARGIOTTI, GERARD ANTHONY III (DO)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:ANTHONY
Last Name:MARGIOTTI
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 ARDSLEY CT.
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940
Mailing Address - Country:US
Mailing Address - Phone:215-378-3582
Mailing Address - Fax:
Practice Address - Street 1:4829 E STREET RD
Practice Address - Street 2:
Practice Address - City:TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6647
Practice Address - Country:US
Practice Address - Phone:215-364-5801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAOS017462207QA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program