Provider Demographics
NPI:1386896843
Name:GALLO, BRIDGET M (LPN)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:M
Last Name:GALLO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 BEECHMONT RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-6683
Mailing Address - Country:US
Mailing Address - Phone:914-403-8761
Mailing Address - Fax:
Practice Address - Street 1:59 BEECHMONT RD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-6683
Practice Address - Country:US
Practice Address - Phone:914-403-8761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY287347164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse