Healthcare Provider Details

I. General information

NPI: 1720128697
Provider Name (Legal Business Name): PATRICIA ANNE GALLO P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

898 OYSTER BAY RD
EAST NORWICH NY
11732-1051
US

IV. Provider business mailing address

127 RENISON DR
WESTBURY NY
11590-1036
US

V. Phone/Fax

Practice location:
  • Phone: 516-624-2602
  • Fax: 516-624-2602
Mailing address:
  • Phone: 516-333-9865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number011252
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: