Individual
DR. CHARLES LAGAYA GELLIDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1005 CLIFTON AVE STE 203, CLIFTON, NJ 07013-3523
(888) 605-3975
(888) 605-3975
Mailing address
1005 CLIFTON AVE STE 203, CLIFTON, NJ 07013-3523
(888) 605-3975
(888) 605-3975
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MA069939
NJ
2084N0600X
Clinical Neurophysiology Physician
230269
NY
2084N0600X
Clinical Neurophysiology Physician
MA69939
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02179353
—
NY
01
—
NONE
COMMERCIAL AND MEDICARE
—
Enumeration date
10/10/2006
Last updated
10/16/2023
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