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General NPI Number Information
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NPI Number | 1194727982
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Entity Type | Individual
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Provider Name | CORNELIUS GALLAGHER MD
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Gender | Male
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Dates
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Enumeration Date | 08/11/2005
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Last Update Date | 09/18/2007
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Provider Practice Location Address
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Address Line | 2640 HWY 70 BLDG 6A
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City | MANASQUAN
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State | NJ
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Zip | 08736
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Country | US
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Telephone | 732-528-5900
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Fax | 732-528-0887
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Provider Business Mailing Address
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Address Line | 2640 HWY 70 BLDG 6A
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City | MANASQUAN
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State | NJ
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Zip | 08736
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Country | US
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Telephone | 732-528-5900
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Fax | 732-528-0887
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | MA50897
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License Number State | NJ
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