Provider Demographics
NPI:1952647919
Name:GALLO, KIRSTEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:GALLO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 STRAWBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-4600
Mailing Address - Country:US
Mailing Address - Phone:856-298-0069
Mailing Address - Fax:
Practice Address - Street 1:34 INDUSTRIAL WAY E STE 6
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-3319
Practice Address - Country:US
Practice Address - Phone:848-245-8950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-19
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03366500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist