Provider Demographics
NPI:1124157649
Name:RICHARD G SAGLIMBENE DPM PC
Entity type:Organization
Organization Name:RICHARD G SAGLIMBENE DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:SAGLIMBENE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:732-349-3039
Mailing Address - Street 1:1163 ROUTE 37 W STE B2
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-4974
Mailing Address - Country:US
Mailing Address - Phone:732-349-3039
Mailing Address - Fax:732-244-3890
Practice Address - Street 1:1163 ROUTE 37 W STE B2
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-4974
Practice Address - Country:US
Practice Address - Phone:732-349-3039
Practice Address - Fax:732-244-3890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00164100213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3328201Medicaid
NJ3328201Medicaid
NJ1253590001Medicare NSC
NJ872561Medicare ID - Type Unspecified