Individual
MARTHA JEAN GALLAHUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LP
Contact information
Practice address
165 W 95TH ST # IMEDSO, NEW YORK, NY 10025-6689
(212) 932-7809
Mailing address
165 W 95TH ST # IMEDSO, NEW YORK, NY 10025-6689
(212) 932-7809
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
000236
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000236
NEW YORK STATE
NY
Enumeration date
02/02/2018
Last updated
02/02/2018
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