Organization
SPARTA CANCER CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J. GALLAGHER MD (MANAGER)
(973) 726-0005
Entity
Organization
Contact information
Practice address
89 SPARTA AVE, SPARTA, NJ 07871-1777
(973) 726-0005
(973) 726-4668
Mailing address
712 MAIN ST, MOOSIC, PA 18507-1094
(570) 451-3910
(570) 451-3236
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0116441
—
NJ
05
—
02834664
—
NY
05
—
101877562
—
PA
Enumeration date
05/11/2006
Last updated
02/01/2013
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