Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 38MC00286800 | NJ |
N | 111NI0013X | Independent Medical Examiner | 38MC00286800 | NJ |
N | 111NN0400X | Neurology | 38MC00286800 | NJ |
N | 111NR0400X | Rehabilitation Chiropractor | 38MC00286800 | NJ |
N | 111NS0005X | Chiropractic Sports Physician | 38MC00286800 | NJ |
N | 111NX0100X | Occupational Health | 38MC00286800 | NJ |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 38MC00286800 | NJ |
NPI | 1326161233 |
---|---|
Provider Name | Steve Gallina |
First Address | Woodbridge, NJ 07095-3158 |
Second Address | Woodbridge, NJ 07095-3158 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2007 |
Last Update Date | 01/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U66872 | (02) | NJ |