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General NPI Number Information
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NPI Number | 1528102043
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Entity Type | Individual
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Provider Name | DR. RICHARD GALASSO
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Gender | Male
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Dates
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Enumeration Date | 02/17/2007
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Last Update Date | 03/14/2011
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Provider Practice Location Address
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Address Line | 242 WASHINGTON AVE
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City | NUTLEY
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State | NJ
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Zip | 07110-3934
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Country | US
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Telephone | 973-271-1936
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Fax | 973-667-1005
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Provider Business Mailing Address
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Address Line | 16 WESTON ST
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City | NUTLEY
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State | NJ
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Zip | 07110-2846
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Country | US
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Telephone | 973-667-6864
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Fax |
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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 | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 38MC00484300
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License Number State | NJ
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