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NPI Code Detail

MEDICARE: JEANNE GALLO PMHNP-BC

MEDICARE: JEANNE GALLO PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerF407691-01NY

General Provider Information

NPI Number : 1891173241
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANNE GALLO PMHNP-BC
Provider Business Mailing Address
First Line : 375 SEGUINE AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10309-3932
Country : US
Telephone Number : 718-226-2000
Fax Number :
Provider Business Practice Location Address
First Line : 375 SEGUINE AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10309-3932
Country : US
Telephone Number : 718-226-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2015
Last Update Date : 03/24/2026

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