Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | Q8479 | TX |
NPI | 1003219155 |
---|---|
Provider Name | Analysa Gallegos |
First Address | Hackensack, NJ 07601-1914 |
Second Address | Hackensack, NJ 07601-1914 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2014 |
Last Update Date | 17/06/2016 |