Provider Demographics
NPI:1922783877
Name:GALLO-PEREZ, IRMA ESTRELLA (MS, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:IRMA
Middle Name:ESTRELLA
Last Name:GALLO-PEREZ
Suffix:
Gender:F
Credentials:MS, PA-C
Other - Prefix:MS
Other - First Name:IRMA
Other - Middle Name:ESTRELLA
Other - Last Name:GALLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, PA-C
Mailing Address - Street 1:1756 OAK HILL DR
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5508
Mailing Address - Country:US
Mailing Address - Phone:201-978-9422
Mailing Address - Fax:
Practice Address - Street 1:1756 OAK HILL DR
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5508
Practice Address - Country:US
Practice Address - Phone:201-978-9422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant