MEDICARE: MS. MARY HELEN GALLERT MS

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	231H00000X	Audiologist	001692	NY
2	231H00000X	Audiologist	9316	NC

General Provider Information

NPI Number	:	1437200813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY HELEN GALLERT MS

Provider Business Mailing Address
First Line	:	1915 K M WICKER MEMORIAL DR
Second Line	:
City	:	SANFORD
State	:	NC
Zip	:	27330-5070
Country	:	US
Telephone Number	:	919-774-6829
Fax Number	:	919-775-2327

Provider Business Practice Location Address
First Line	:	1915 K M WICKER MEMORIAL DR
Second Line	:
City	:	SANFORD
State	:	NC
Zip	:	27330-5070
Country	:	US
Telephone Number	:	919-774-6829
Fax Number	:	919-775-2327

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

Provider Enumeration Date	:	01/14/2007
Last Update Date	:	05/10/2016

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