Individual provider Active NPI

Eleonora V. Gallagher, PSY.D.

  • Clinical Neuropsychologist
  • Brick, NJ
National Provider Identifier
1427713627
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
35SI00729700 Issued in NJ
Practice address
990 Cedar Bridge Ave # B7-152
Brick, NJ 08723-4159
Phone
(732) 503-8479
NPI assigned
Nov 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 35SI00729700 NJ
Student in an Organized Health Care Education/Training Program 390200000X 213-079 NJ
Clinical Neuropsychologist 103G00000X 35SI00729700 NJ Primary

Addresses

Primary practice location

990 Cedar Bridge Ave # B7-152
Brick, NJ 08723-4159

Mailing address

990 Cedar Bridge Ave # B7-152
Brick, NJ 08723-4159
Phone (917) 703-3840

Other practice location 1

4000 Route 66 Ste 331
Tinton Falls, NJ 07753-7300
Phone (732) 988-3441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231220000380 NJ Practitioner - Clinical Psychologist 3476903287 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

990 Cedar Bridge Ave
B7152
Brick, NJ 08723-4159
Phone (917) 703-3840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
213-079NJMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Neuropsychological Services CurrentSince Sep 5, 2024 Accepting new patients

Locations

990 Cedar Bridge Ave
#B7152
Brick, NJ 08723
Phone (732) 503-8479

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1427713627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 CEDAR BRIDGE AVE # B7-152",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087234159",
            "telephone_number": "917-703-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 CEDAR BRIDGE AVE # B7-152",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087234159",
            "telephone_number": "732-503-8479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Route 66 Ste 331",
            "address_purpose": "LOCATION",
            "city": "Tinton Falls",
            "state": "NJ",
            "postal_code": "077537300",
            "country_code": "US",
            "telephone_number": "732-988-3441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "ELEONORA",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-02",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00729700",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NJ",
            "license": "213-079",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NJ",
            "license": "35SI00729700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.