Active NPI
Jacqueline Gallo
- Physical Therapist
- Franklin Lakes, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA02085700
- Practice address
- 795 Franklin Ave
Franklin Lakes, NJ 07417-1368 - Phone
- (201) 847-8585
- NPI assigned
- Jul 12, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA02085700 | NJ | Primary |
Addresses
Primary practice location
795 Franklin Ave
Franklin Lakes, NJ 07417-1368
Mailing address
1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Other practice location 1
263 Beechwood Rd
Oradell, NJ 07649-1807
Phone (201) 835-3522
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
454 Passaic St
Hackensack, NJ 07601-1519
Phone (201) 488-7905
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA02085700 | NJ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ivyrehab Network, Inc. | Physical Therapist | Current | Accepting new patients |
| Ivyrehab Network Inc. | Physical Therapist | Current | Accepting new patients |
Locations
795 Franklin Ave
Franklin Lks, NJ 07417
Phone (201) 639-6620
454 Passaic St
Hackensack, NJ 07601
Phone (201) 488-7905
1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838
Organizations & group practices 2
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.
-
- Physical Therapist
- Hoboken, NJ
- NPI 1174577274
-
- Physical Medicine & Rehabilitation Physician
- Cranford, NJ
- NPI 1699590265
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657584000000",
"number": "1932833407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1311 MAMARONECK AVE STE 140",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106055224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "795 FRANKLIN AVE",
"city": "FRANKLIN LAKES",
"state": "NJ",
"postal_code": "074171368",
"telephone_number": "201-847-8585"
}
],
"practiceLocations": [
{
"address_1": "263 Beechwood Rd",
"address_purpose": "LOCATION",
"city": "Oradell",
"state": "NJ",
"postal_code": "076491807",
"country_code": "US",
"telephone_number": "201-835-3522",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GALLO",
"first_name": "JACQUELINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-12",
"last_updated": "2022-07-12",
"certification_date": "2022-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA02085700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Franklin Lakes, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.