Provider Demographics
NPI:1376303933
Name:GALLUB, VINCENT (DO)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
Last Name:GALLUB
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 TENTH AVE
Mailing Address - Street 2:3RD FLOOR, ROOM 3A-08
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019
Mailing Address - Country:US
Mailing Address - Phone:212-259-6777
Mailing Address - Fax:
Practice Address - Street 1:1000 TENTH AVE
Practice Address - Street 2:3RD FLOOR, ROOM 3A-08
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019
Practice Address - Country:US
Practice Address - Phone:212-523-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program