Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 26NN06456500 | NJ |
NPI | 1023052289 |
---|---|
Provider Name | Mrs. Nancy P Gallagher |
First Address | Fair Lawn, NJ 07410-3016 |
Second Address | Fair Lawn, NJ 07410-3016 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 07/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P98751 | (02) | NJ |