Provider Demographics
NPI:1841208873
Name:GALLAGHER, JOSEPH T (PT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:T
Last Name:GALLAGHER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 CLOVER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MICKLESTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08056
Mailing Address - Country:US
Mailing Address - Phone:856-468-8248
Mailing Address - Fax:
Practice Address - Street 1:390N BROADWAY
Practice Address - Street 2:STE 400 HEARTLAND REHABILITATION SERVICE OF NJ INC
Practice Address - City:PENNSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08070
Practice Address - Country:US
Practice Address - Phone:856-678-7011
Practice Address - Fax:856-678-2820
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00867700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist