Provider Demographics
NPI:1871730010
Name:ANTHONY J. DIGILIO JR., M.D. P.A.
Entity type:Organization
Organization Name:ANTHONY J. DIGILIO JR., M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:URIBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-751-8900
Mailing Address - Street 1:116 GORDON RD
Mailing Address - Street 2:
Mailing Address - City:ESSEX FELLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07021-1622
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:116 GORDON RD
Practice Address - Street 2:
Practice Address - City:ESSEX FELLS
Practice Address - State:NJ
Practice Address - Zip Code:07021-1622
Practice Address - Country:US
Practice Address - Phone:973-751-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03060100207L00000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1025309Medicaid
NJ034546Medicare PIN