Healthcare Provider Details
I. General information
NPI: 1538377726
Provider Name (Legal Business Name): AVI STERNSTEIN GALLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/19/2007
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 BOWMAN DR STE E366
VOORHEES NJ
08043-9639
US
IV. Provider business mailing address
711 S LEITHGOW ST
PHILADELPHIA PA
19147-3114
US
V. Phone/Fax
- Phone: 856-247-7295
- Fax: 856-247-7118
- Phone: 215-935-6374
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208C00000X |
| Taxonomy | Colon & Rectal Surgery Physician |
| License Number | 25MA09053500 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: