Active NPI
Susan Maureen Gavallas, D.C.
- Chiropractor
- Monroe Township, NJ
National Provider Identifier
1770610412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 38MC00644600
- Practice address
- 957 Route 33
Monroe Township, NJ 08831 - Phone
- (848) 468-6994
- NPI assigned
- Feb 28, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38MC00644600 | NJ | Primary |
Addresses
Primary practice location
957 Route 33
Monroe Township, NJ 08831
Mailing address
325 State Route 79
Morganville, NJ 07751-2004
Phone (732) 591-5761
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
| License | State | Type | Specialty |
|---|---|---|---|
| 38MC00644600 | NJ | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288828800000",
"number": "1770610412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 STATE ROUTE 79",
"city": "MORGANVILLE",
"state": "NJ",
"postal_code": "077512004",
"telephone_number": "732-591-5761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "957 ROUTE 33",
"city": "MONROE TOWNSHIP",
"state": "NJ",
"postal_code": "08831",
"telephone_number": "848-468-6994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAVALLAS",
"first_name": "SUSAN",
"middle_name": "MAUREEN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-28",
"last_updated": "2010-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NJ",
"license": "38MC00644600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe Township, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.