Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | SI02831 | NJ |
NPI | 1891894598 |
---|---|
Provider Name | Nancy Burleigh Gallina |
First Address | Wyckoff, NJ 07481 |
Second Address | Wyckoff, NJ 07481 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 08/07/2007 |