Healthcare Provider Details

I. General information

NPI: 1841229457
Provider Name (Legal Business Name): JOSEPH L GALLAGHER III DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 02/02/2022
Certification Date: 02/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

485 HURFFVILLE CROSSKEYS RD
SEWELL NJ
08080-9369
US

IV. Provider business mailing address

485 HURFFVILLE CROSSKEYS RD
SEWELL NJ
08080-9369
US

V. Phone/Fax

Practice location:
  • Phone: 856-557-5555
  • Fax:
Mailing address:
  • Phone: 856-557-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MB07812200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: