Provider Demographics
NPI:1053396713
Name:SAGLIMBENE, RICHARD G (DPM PC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:G
Last Name:SAGLIMBENE
Suffix:
Gender:M
Credentials:DPM PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1163 HIGHWAY 37 SUITE 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 HIGHWAY 37 SUITE 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
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00164100213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3328201Medicaid
NJ872561Medicare ID - Type Unspecified
NJ3328201Medicaid