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Individual
MR. SHANE DANIEL GALLAGHER
Active
Individual
MR. SHANE DANIEL GALLAGHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
703317
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402369
NY
Other
Enumeration date
07/18/2017
Last updated
07/03/2018
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