John Anthony Gallucci Jr, MS, ATC, PT | |
622 Eagle Rock Ave, West Orange, NJ 07052-2994 | |
(973) 669-0078 | |
(973) 669-1113 |
Full Name | John Anthony Gallucci Jr |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 622 Eagle Rock Ave, West Orange, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1346314093 | NPI | - | NPPES |
027198-1 | Other | NY | NY PHYSICAL THERAPY LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 40QA01172700 (New Jersey) | Primary |
Provider Name | Jag-one Physical Therapy Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1518017144 PECOS PAC ID: 2769584325 Enrollment ID: O20070228000306 |
Mailing Address | Practice Location Address |
---|---|
John Anthony Gallucci Jr, MS, ATC, PT 622 Eagle Rock Ave, West Orange, NJ 07052-2994 Ph: (973) 669-0078 | John Anthony Gallucci Jr, MS, ATC, PT 622 Eagle Rock Ave, West Orange, NJ 07052-2994 Ph: (973) 669-0078 |
Elizabeth Caputo, PT, DPT, NCS Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1199 Pleasant Valley Way, West Orange, NJ 07052 Phone: 973-243-6940 Fax: 973-243-6967 | |
David Currie King, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1199 Pleasant Valley Way, West Orange, NJ 07052 Phone: 973-414-4755 Fax: 973-243-6842 | |
Dr. Sandra Wojciehowski, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1199 Pleasant Valley Way, West Orange, NJ 07052 Phone: 973-414-4755 | |
Raphael Moreno, Physical Therapist Medicare: Medicare Enrolled Practice Location: 622 Eagle Rock Ave, West Orange, NJ 07052 Phone: 973-669-0078 | |
Jaceline D Dejean, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 445 Pleasant Valley Way, West Orange, NJ 07052 Phone: 862-520-4027 | |
Abigail Reid, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1199 Pleasant Valley Way, West Orange, NJ 07052 Phone: 973-414-4755 Fax: 973-243-6967 | |
Ms. Leslie Prendergast, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 44 Manger Rd, West Orange, NJ 07052 Phone: 973-736-7121 |