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General NPI Number Information
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NPI Number | 1164753471
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Entity Type | Individual
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Provider Name | LAURIE ANNE GALLO PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/26/2010
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Last Update Date | 01/26/2010
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Provider Practice Location Address
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Address Line | 111 E 210TH ST
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City | BRONX
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State | NY
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Zip | 10467-2401
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Country | US
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Telephone | 718-920-7935
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Fax |
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Provider Business Mailing Address
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Address Line | 25 COUNTY CENTER RD APT. C3
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City | WHITE PLAINS
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State | NY
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Zip | 10607-1534
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Country | US
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Telephone | 914-860-5359
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 018024
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 018024
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License Number State | NY
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