Individual
DR. BENJAMIN P JAGIELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
ONE LANDMARK NORTH 20399 ROUTE 19, SUITE 203, CRANBERRY TWP, PA 16066
(724) 772-8000
(724) 772-8040
Mailing address
1605 LAKES PKWY, LAWRENCEVILLE, GA 30043-5858
(904) 819-4478
(904) 819-4993
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MD038951E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016475970005
—
PA
Enumeration date
04/11/2006
Last updated
08/01/2007
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