Healthcare Provider Details

I. General information

NPI: 1902050008
Provider Name (Legal Business Name): DAVID JAMES GALLAGHER MB BCH BAO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2008
Last Update Date: 11/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1233 YORK AVE APARTMENT 21N
NEW YORK NY
10065-6306
US

IV. Provider business mailing address

1233 YORK AVE APARTMENT 21N
NEW YORK NY
10065-6306
US

V. Phone/Fax

Practice location:
  • Phone: 917-257-8237
  • Fax:
Mailing address:
  • Phone: 917-257-8237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberP53957
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: