Healthcare Provider Details

I. General information

NPI: 1376575662
Provider Name (Legal Business Name): DELLIS A NORWOOD-GALLOWAY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 PONDFIELD RD
BRONXVILLE NY
10708-3809
US

IV. Provider business mailing address

77 PONDFIELD RD
BRONXVILLE NY
10708-3809
US

V. Phone/Fax

Practice location:
  • Phone: 914-337-4986
  • Fax:
Mailing address:
  • Phone: 914-337-4986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1657751
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: