Healthcare Provider Details

I. General information

NPI: 1871170464
Provider Name (Legal Business Name): ALEXANDER GALLAGHER STAVROS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2021
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 HADDON AVE FL 3
CAMDEN NJ
08103-3101
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 609-988-6260
  • Fax: 856-988-6270
Mailing address:
  • Phone: 609-988-6260
  • Fax: 856-988-6270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD490681
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA12997800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: