Provider Demographics
NPI:1255412391
Name:GALLARDO, MARY ROSE RAMOS (MD)
Entity type:Individual
Prefix:DR
First Name:MARY ROSE
Middle Name:RAMOS
Last Name:GALLARDO
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1608 ROUTE88 WEST
Mailing Address - Street 2:SUITE 104-C
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724
Mailing Address - Country:US
Mailing Address - Phone:732-785-9080
Mailing Address - Fax:732-785-9084
Practice Address - Street 1:1608 ROUTE 88
Practice Address - Street 2:SUITE 104-C
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3009
Practice Address - Country:US
Practice Address - Phone:732-785-9080
Practice Address - Fax:732-785-9084
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA0644442080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine