Healthcare Provider Details

I. General information

NPI: 1235431560
Provider Name (Legal Business Name): DENISE GALLO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DENISE COOKE

II. Dates (important events)

Enumeration Date: 11/18/2010
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1343 BOSTON POST ROAD SUITE 101
MADISON CT
06443-3481
US

IV. Provider business mailing address

4700 EXCHANGE CT STE 110
BOCA RATON FL
33431-4450
US

V. Phone/Fax

Practice location:
  • Phone: 860-669-6156
  • Fax: 860-664-0285
Mailing address:
  • Phone: 860-669-6156
  • Fax: 860-664-0285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4551
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: