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NPI Code Detail

MEDICARE: ROBERT GALLAGHER LCSW

MEDICARE:   ROBERT  GALLAGHER  LCSW
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
11041C0700XClinical Social WorkerR045818-1NY

General Provider Information

NPI Number : 1972528727
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT GALLAGHER LCSW
Provider Business Mailing Address
First Line : 1110 SOUTH AVE STE 46
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-3403
Country : US
Telephone Number : 718-983-9200
Fax Number : 732-617-8784
Provider Business Practice Location Address
First Line : 1110 SOUTH AVE STE 46
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-3403
Country : US
Telephone Number : 718-983-9200
Fax Number : 732-617-8784
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2006
Last Update Date : 02/28/2019

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