Rivera, Carlos Gallegos

Rivera, Carlos Gallegos is an individual health care provider with primary practice located at 9 Memorial Pkwy , Long Branch NJ 07740-6701. He recently has only one registered license in Other Service Providers / Legal Medicine, which is considered as his primary health care specialty. Rivera, Carlos Gallegos can be contacted via phone (732) 728-7010.

Contact Information

Primary practice address
9 Memorial Pkwy Long Branch NJ 07740-6701
Phone: (732) 728-7010
Fax: (732) 728-0704
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Legal Medicine 173000000X 25MA06184200 New Jersey

Profile Details

NPI number 1992741326
LBN Legal business name Rivera, Carlos Gallegos
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Feb 8th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992741326 NPPES
New Jersey Other 31D0941981 CLIA NUMBER
New Jersey Other 223601506 CLIA NUMBER
New Jersey MEDICAID 6635008 CLIA NUMBER

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