Provider Demographics
NPI:1699766246
Name:STIGLIANO FAMILY PRACTICE PC
Entity type:Organization
Organization Name:STIGLIANO FAMILY PRACTICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:STIGLIANO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:724-342-5335
Mailing Address - Street 1:3140 HIGHLAND RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-4514
Mailing Address - Country:US
Mailing Address - Phone:724-342-5335
Mailing Address - Fax:724-346-3001
Practice Address - Street 1:3140 HIGHLAND RD
Practice Address - Street 2:SUITE 102
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-4514
Practice Address - Country:US
Practice Address - Phone:724-342-5335
Practice Address - Fax:724-346-3001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-02
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018258950002Medicaid
PA0018258950002Medicaid