Healthcare Provider Details

I. General information

NPI: 1326161233
Provider Name (Legal Business Name): STEVE GALLINA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 07/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 AMBOY AVE
WOODBRIDGE NJ
07095-3158
US

IV. Provider business mailing address

676 AMBOY AVE
WOODBRIDGE NJ
07095-3158
US

V. Phone/Fax

Practice location:
  • Phone: 732-750-0011
  • Fax: 732-750-1177
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00286800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number38MC00286800
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number38MC00286800
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number38MC00286800
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number38MC00286800
License Number StateNJ
# 6
Primary TaxonomyN
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License Number38MC00286800
License Number StateNJ
# 7
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number38MC00286800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: