Leza N Gallo, M.D.

Individual provider Active NPI Anatomic Pathology Physician · Teterboro, NJ

NPI 1083709208 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1083709208
Entity type
Individual (NPI type 1)
Primary specialty
Anatomic Pathology Physician 207ZP0101X
License
155749 (MA)
Practice address
Quest Diagnostics
1 Malcolm Avenue
Teterboro, NJ 07608
Phone
(201) 393-5035
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
155749MAMDAnatomic Pathology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 155749 MA Yes

Addresses

Primary practice location

Quest Diagnostics
1 Malcolm Avenue
Teterboro, NJ 07608

Mailing address

320 E 72ND St
#6B
New York, NY 10021-4769
Phone (201) 393-5035

Other providers in Teterboro, NJ

All providers in Teterboro, NJ · Anatomic Pathology Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.