Healthcare Provider Details

I. General information

NPI: 1285024554
Provider Name (Legal Business Name): HELEN SHEILA GALLAGHER RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2015
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4560 CRAIN HIGHWAY SUITE II
WHITE PLAINS MD
20695-3084
US

IV. Provider business mailing address

6015 HILL ROAD
SAINT LEONARD MD
20685-2517
US

V. Phone/Fax

Practice location:
  • Phone: 240-270-1131
  • Fax: 301-877-4376
Mailing address:
  • Phone: 443-624-3202
  • Fax: 301-877-4376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License NumberD01022
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: