Provider Demographics
NPI:1609111616
Name:GALLAGHER, DONNA (MS, RD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 BROAD ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-2044
Mailing Address - Country:US
Mailing Address - Phone:732-747-3663
Mailing Address - Fax:
Practice Address - Street 1:272 BROAD ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-2044
Practice Address - Country:US
Practice Address - Phone:732-747-3663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-02
Last Update Date:2012-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered