Individual
KERRIE GALLAGHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
445 GODWIN AVE, MIDLAND PARK, NJ 07432-1507
(201) 444-4991
Mailing address
26 BROOKWOOD DR, MAHWAH, NJ 07430-1505
(201) 825-1393
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40QB00099800
LICENSE#
NJ
Enumeration date
11/01/2006
Last updated
07/08/2007
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