Provider Demographics
NPI:1295944973
Name:GALLAGHER, CAROL (APN)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 BIRCH HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:BORDENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08505-4236
Mailing Address - Country:US
Mailing Address - Phone:609-499-0806
Mailing Address - Fax:
Practice Address - Street 1:2540 US HIGHWAY 130 STE 118
Practice Address - Street 2:
Practice Address - City:CRANBURY
Practice Address - State:NJ
Practice Address - Zip Code:08512-3519
Practice Address - Country:US
Practice Address - Phone:877-679-7737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN06265400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily