Provider Demographics
NPI:1902982929
Name:GALLO, BARBARA A (RN,NP-P)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:GALLO
Suffix:
Gender:F
Credentials:RN,NP-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 EAST 234TH STREET
Mailing Address - Street 2:APT. #2
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10470-2251
Mailing Address - Country:US
Mailing Address - Phone:718-653-9297
Mailing Address - Fax:
Practice Address - Street 1:3600 JEROME AVENUE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-1052
Practice Address - Country:US
Practice Address - Phone:718-881-7600
Practice Address - Fax:718-796-4138
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF4001291163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY91N171Medicare UPIN