Healthcare Provider Details

I. General information

NPI: 1982917951
Provider Name (Legal Business Name): NORA MARTA GALLARDO R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NORA MARTA HAMOND-GALLARDO

II. Dates (important events)

Enumeration Date: 07/20/2010
Last Update Date: 07/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 MAIDEN LN
NEW YORK NY
10038-4810
US

IV. Provider business mailing address

75 MAIDEN LN
NEW YORK NY
10038-4810
US

V. Phone/Fax

Practice location:
  • Phone: 212-477-6100
  • Fax:
Mailing address:
  • Phone: 212-477-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number218575-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: