1972542280 NPI number — THOMAS J GALLAGHER DO

Table of content: THOMAS J GALLAGHER DO (NPI 1972542280)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972542280 NPI number — THOMAS J GALLAGHER DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GALLAGHER
Provider First Name:
THOMAS
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972542280
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/24/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
901 ROUTE 168
Provider Second Line Business Mailing Address:
WASHINGTON PROFESSIONAL CAMPUS II, SUITES 301-305
Provider Business Mailing Address City Name:
TURNERSVILLE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08012-3210
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-374-4031
Provider Business Mailing Address Fax Number:
856-232-9139

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
901 ROUTE 168
Provider Second Line Business Practice Location Address:
WASHINGTON PROFESSIONAL CAMPUS II, SUITES 301-305
Provider Business Practice Location Address City Name:
TURNERSVILLE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08012-3210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-374-4031
Provider Business Practice Location Address Fax Number:
856-232-9139
Provider Enumeration Date:
06/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  25MB07834500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: A3738029 . This is a "OXFORD HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0060119 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2360542000 . This is a "AMERIHEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60018627 . This is a "HORIZON NJ HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00431854 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com