Individual
MARY GALLINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
168 CLUBHOUSE DR, PATCHOGUE, NY 11772-8202
(631) 965-1276
Mailing address
PO BOX 2537, LAKE RONKONKOMA, NY 11779-0409
(631) 965-1276
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
12/15/2022
Last updated
12/15/2022
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