MEDICARE: MRS. YAMILLETH GALLUCCIO BILINGUAL-TSHH

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	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1558643445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. YAMILLETH GALLUCCIO BILINGUAL-TSHH

Provider Business Mailing Address
First Line	:	40 89TH ST
Second Line	:	APT 2G
City	:	BROOKLYN
State	:	NY
Zip	:	11209-5551
Country	:	US
Telephone Number	:	718-290-6999
Fax Number	:

Provider Business Practice Location Address
First Line	:	454 BAY RIDGE AVE
Second Line	:	GROUND LEVEL
City	:	BROOKLYN
State	:	NY
Zip	:	11220-5906
Country	:	US
Telephone Number	:	718-333-5665
Fax Number	:

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

Provider Enumeration Date	:	09/15/2011
Last Update Date	:	09/15/2011

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