Individual
IVAN GALLEGOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
320 CARLETON AVE, SUITE 7000, CENTRAL ISLIP, NY 11722-4506
(631) 517-9261
(631) 517-9276
Mailing address
320 CARLETON AVE, SUITE 7000, CENTRAL ISLIP, NY 11722-4506
(631) 517-9261
(631) 517-9276
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
205128
NY
Other
Enumeration date
05/27/2015
Last updated
05/27/2015
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