Individual
DR. MARIO M SANGILLO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2025 TECHNOLOGY PKWY, STE 108, MECHANICSBURG, PA 17050-9400
(717) 791-2680
(717) 791-2688
Mailing address
36 W BAYBERRY DRIVE, HARRISBURG, PA 17112
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD026221E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008697970006
—
PA
01
—
01464401
CAIC
PA
01
—
SA054783
HIGHMARK BLUE SHIELD
PA
Enumeration date
08/15/2005
Last updated
07/08/2007
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