Individual
TANYA GALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CASAC-T
Contact information
Practice address
273 HEBERTON AVE, STATEN ISLAND, NY 10302-1809
(718) 412-3170
Mailing address
273 HEBERTON AVE, STATEN ISLAND, NY 10302-1809
(718) 412-3170
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37673
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
XN75960H
—
NY
Enumeration date
06/28/2022
Last updated
06/28/2022
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