Healthcare Provider Details

I. General information

NPI: 1144340852
Provider Name (Legal Business Name): DANIELLE GALL PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 E 76TH ST APT 3B
NEW YORK NY
10021-3117
US

IV. Provider business mailing address

418 E 76TH ST APT 3B
NEW YORK NY
10021-3117
US

V. Phone/Fax

Practice location:
  • Phone: 201-240-6858
  • Fax:
Mailing address:
  • Phone: 212-746-0221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number023823
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: