Individual
DR. MARIEL ANN GALLEGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1111 AMSTERDAM AVE, CLARK 6TH FLOOR, NEW YORK, NY 10025-1716
(212) 523-6500
(212) 523-5677
Mailing address
1111 AMSTERDAM AVE, CLARK 6TH FLOOR, NEW YORK, NY 10025-1716
(212) 523-6500
(212) 523-5677
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
019195
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03394272
—
NY
01
—
A400136789
MEDICARE PTAN
NY
Enumeration date
07/19/2010
Last updated
09/26/2016
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