Individual provider Active NPI

Kristen Gallicchio, DVM

  • Veterinarian
  • East Brunswick, NJ
National Provider Identifier
1215339460
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
VeterinarianTaxonomy code 174M00000X
License
29VI00592400 Issued in NJ
Practice address
300 Route 18
East Brunswick, NJ 08816-1912
Phone
(732) 432-8005
NPI assigned
Sep 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Veterinarian 174M00000X 29VI00592400 NJ Primary

Addresses

Primary practice location

300 Route 18
East Brunswick, NJ 08816-1912

Mailing address

300 Route 18
East Brunswick, NJ 08816-1912
Phone (732) 432-8005

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
29VI00592400NJMDVeterinarian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1215339460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 ROUTE 18",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088161912",
            "telephone_number": "732-432-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ROUTE 18",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088161912",
            "telephone_number": "732-432-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLICCHIO",
        "first_name": "KRISTEN",
        "credential": "DVM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-18",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "NJ",
            "license": "29VI00592400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.