Individual
GIANNINA M GALLAGHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
301 EAST MAIN STREET, BAY SHORE, NY 11706
(631) 968-3000
Mailing address
301 EAST MAIN STREET, BAY SHORE, NY 11706
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
015246
NY
Other
Enumeration date
11/03/2011
Last updated
12/29/2015
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