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NPI Code Detail

MEDICARE: JASON M GALLINA MD PC

MEDICARE: JASON M GALLINA MD PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician234845NY

General Provider Information

NPI Number : 1518121052
Entity Type Code : Organization
Provider Name (Legal Business Name) : JASON M GALLINA MD PC
Provider Business Mailing Address
First Line : PO BOX 182
Second Line :
City : NEW YORK
State : NY
Zip : 10163-0182
Country : US
Telephone Number : 212-616-4130
Fax Number : 212-691-6370
Provider Business Practice Location Address
First Line : 820 2ND AVE
Second Line : 7TH FLOOR
City : NEW YORK
State : NY
Zip : 10017-4504
Country : US
Telephone Number : 212-616-4130
Fax Number : 212-691-6370
Authorized Official
Title or Position : PRESIDENT
Name : JASON M GALLINA
Credential : M.D.
Telephone Number : 212-616-4130
Provider Enumeration Date : 07/14/2008
Last Update Date : 12/29/2010

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