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Individual

DR. CARLOS GALLEGOS RIVERA

Active
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Individual

DR. CARLOS GALLEGOS RIVERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.,

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
25MA06184200
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
223601506
TAX ID
NJ
01
—
31D0941981
CLIA NUMBER
NJ
05
—
6635008
—
NJ
Enumeration date
06/22/2006
Last updated
02/08/2013
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