Organization
BERGEN INTERNAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD JUSTIN GALLO MD (PRESIDENT)
(201) 886-8989
Entity
Organization
Contact information
Practice address
6 HORIZON RD, FORT LEE, NJ 07024-6652
(201) 886-8989
(201) 886-8990
Mailing address
6 HORIZON RD, FORT LEE, NJ 07024-6652
(201) 886-8989
(201) 886-8990
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA54263
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4992806
—
NJ
Enumeration date
05/04/2009
Last updated
10/17/2014
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