MEDICARE: MS. DANIELLE GALL PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251N0400X	Neurology Physical Therapist	023823	NY

General Provider Information

NPI Number	:	1144340852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DANIELLE GALL PT

Provider Business Mailing Address
First Line	:	418 E 76TH ST APT 3B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-3117
Country	:	US
Telephone Number	:	212-746-0221
Fax Number	:

Provider Business Practice Location Address
First Line	:	418 E 76TH ST APT 3B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-3117
Country	:	US
Telephone Number	:	201-240-6858
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	07/08/2007

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