MEDICARE: RAYMOND J GALLO JR. PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	006561-1	NY
2	225100000X	Physical Therapist	PT026630	PA

General Provider Information

NPI Number	:	1053367292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAYMOND J GALLO JR. PT

Provider Business Mailing Address
First Line	:	419 VILLAGE DR STE 3
Second Line	:
City	:	CARLISLE
State	:	PA
Zip	:	17015-6943
Country	:	US
Telephone Number	:	717-240-0330
Fax Number	:	717-240-0233

Provider Business Practice Location Address
First Line	:	419 VILLAGE DR STE 3
Second Line	:
City	:	CARLISLE
State	:	PA
Zip	:	17015-6943
Country	:	US
Telephone Number	:	717-240-0330
Fax Number	:	717-240-0233

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	03/13/2018

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