Individual
MINA GABALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
90 BERGEN ST STE 3400, NEWARK, NJ 07103-2425
(973) 972-2085
Mailing address
11 MCCORMICK AVE N, OLD BRIDGE, NJ 08857-3839
(732) 556-7010
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MB11236800
NJ
207LP2900X
Pain Medicine (Anesthesiology) Physician
25MB11236800
NJ
Other
Enumeration date
04/15/2017
Last updated
04/12/2024
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