Individual
AMY ELIZABETH GALLETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4849 OTISCO RD, TULLY, NY 13159-3086
(315) 696-8592
Mailing address
25 N POLLARD DR, FULTON, NY 13069-3432
(315) 598-6390
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2242841
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01535139
—
NY
Enumeration date
03/21/2007
Last updated
07/09/2007
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