Maryellen Gallick, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00460300 Issued in NJ

Practice address

2250 Echelon Mall
Voorhees, NJ 08043-1943

Phone

(856) 772-6331

NPI assigned

Dec 30, 2005

Last updated

Feb 6, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Eyecare Specialties Support of NJ PC

  • Optometrist
  • Blackwood, NJ
  • NPI 1003601287
  NPD (past)

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391644800000",
    "number": "1780661660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 ECHELON MALL",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080431943",
            "telephone_number": "856-772-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 ECHELON MALL",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080431943",
            "telephone_number": "856-772-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLICK",
        "first_name": "MARYELLEN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2014-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00460300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Gallagher
• Claudia Gallelli, RPH, MBA
• Joseph Pasquale Gallelli, D.M.D.
• Pasquale J Gallelli, DMD
• Avi Sternstein Galler, M.D.
• James Gamble, M.D
• Frances Ganaden
• Janvi Gandhi, DPM
• Riddhi Gandhi, MD
• Veena S Gandhi

• Optometrist in Voorhees, NJ
• Providers in Voorhees, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.