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NPI Code Detail

MEDICARE: GUILLERMO GILBERTO GALLARDO MD PLLC

MEDICARE: GUILLERMO GILBERTO GALLARDO MD PLLC
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
1207W00000XOphthalmology Physician

General Provider Information

NPI Number : 1508468299
Entity Type Code : Organization
Provider Name (Legal Business Name) : GUILLERMO GILBERTO GALLARDO MD PLLC
Provider Business Mailing Address
First Line : 2922 AVENUE L
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-4639
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2922 AVENUE L
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-4639
Country : US
Telephone Number : 718-758-2020
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : GUILLERMO G GALLARDO
Credential : MD
Telephone Number : 718-758-2020
Provider Enumeration Date : 11/09/2020
Last Update Date : 11/09/2020

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