MEDICARE: DENISE GALLO APRN

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	363LF0000X	Family Nurse Practitioner	4551	CT

General Provider Information

NPI Number	:	1235431560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE GALLO APRN

Provider Business Mailing Address
First Line	:	13 PARK ST
Second Line	:	SKIN CARE PHYSICIANS OF FAIRFIELD COUNTY
City	:	NORWALK
State	:	CT
Zip	:	06851-4811
Country	:	US
Telephone Number	:	203-847-2400
Fax Number	:

Provider Business Practice Location Address
First Line	:	13 PARK ST
Second Line	:
City	:	NORWALK
State	:	CT
Zip	:	06851-4811
Country	:	US
Telephone Number	:	203-853-1874
Fax Number	:

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

Provider Enumeration Date	:	11/18/2010
Last Update Date	:	03/12/2015

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Directions to “ DENISE GALLO APRN” Practice Location

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