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Individual

JOHN ANTHONY GALLUCCI JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, ATC, PT

Contact information

Practice address
622 EAGLE ROCK AVE, WEST ORANGE, NJ 07052-2994
(973) 669-0078
(973) 669-1113
Mailing address
622 EAGLE ROCK AVE, WEST ORANGE, NJ 07052-2994
(973) 669-0078
(973) 669-1113

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01172700
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
027198-1
NY PHYSICAL THERAPY LICENSE
NY
Enumeration date
11/17/2006
Last updated
01/15/2014
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