=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659647220
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KRISTEN GIALO D.O.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/28/2012
-----------------------------------------------------
Last Update Date | 06/02/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 127 N WEST ST STE 1
-----------------------------------------------------
City | EASTON
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21601-2758
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-541-8403
-----------------------------------------------------
Fax | 866-481-2328
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 127 N WEST ST STE 1
-----------------------------------------------------
City | EASTON
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21601-2758
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-541-8403
-----------------------------------------------------
Fax | 866-481-2328
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | H0081152
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------