Provider Demographics
NPI:1548374721
Name:GALL & CASTERLINE PC
Entity type:Organization
Organization Name:GALL & CASTERLINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:GALL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-510-8051
Mailing Address - Street 1:PO BOX 948
Mailing Address - Street 2:
Mailing Address - City:GREEN BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08812-0948
Mailing Address - Country:US
Mailing Address - Phone:732-968-3900
Mailing Address - Fax:732-968-3944
Practice Address - Street 1:309 ROCK AVE
Practice Address - Street 2:
Practice Address - City:GREEN BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08812-2616
Practice Address - Country:US
Practice Address - Phone:732-968-3900
Practice Address - Fax:732-968-3944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC03899111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ541474OtherAETNA ID #
NJP406638OtherOXFORD ID
NJ0454734000OtherAMERIHEALTH ID
NJ625109Medicare ID - Type UnspecifiedMEDICARE ID #
NJ0454734000OtherAMERIHEALTH ID