Healthcare Provider Details

I. General information

NPI: 1891482345
Provider Name (Legal Business Name): PAULA GALLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2023
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 KINGS HWY
BROOKLYN NY
11223-1105
US

IV. Provider business mailing address

1702 W 7TH ST APT 3BR
BROOKLYN NY
11223-1393
US

V. Phone/Fax

Practice location:
  • Phone: 718-331-2019
  • Fax:
Mailing address:
  • Phone: 347-219-1479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number10035885
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: