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General NPI Number Information
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NPI Number | 1962529727
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Entity Type | Individual
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Provider Name | MARC B. GALLOWAY L.C.S.W.
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Gender | Male
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Dates
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Enumeration Date | 03/24/2007
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Last Update Date | 05/24/2011
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Provider Practice Location Address
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Address Line | 19 CHESTNUT ST
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City | MASSAPEQUA
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State | NY
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Zip | 11758-5120
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Country | US
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Telephone | 516-528-5876
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Fax |
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Provider Business Mailing Address
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Address Line | 53 E MERRICK RD UNIT 2 SUITE # 161
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City | FREEPORT
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State | NY
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Zip | 11520-4056
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Country | US
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Telephone | 516-528-5876
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 5705213
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number |
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License Number State | NY
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