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Individual

ELIZABETH GALLEGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CM

Contact information

Practice address
760 BROADWAY, WOODHULL MENTAL & MEDICAL HEALTH CENTER, BROOKLYN, NY 11206
(718) 963-8000
(201) 996-4432
Mailing address
760 BROADWAY DEPARTMENT OF MANAGED CARE ROOM 2B230, WOODHULL MENTAL & MEDICAL HEALTH CENTER, BROOKLYN, NY 11206
(718) 963-8000
(718) 630-3122

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
25MM00000900
NJ
367A00000X
Advanced Practice Midwife
F001201
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CM0055
CERTIFICATION NUMBER
NY
Enumeration date
06/05/2007
Last updated
07/08/2014
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