Individual
MARY CARNESALE GALLAGHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1115 BROADWAY FL 12, NEW YORK, NY 10010-3452
(917) 960-3061
Mailing address
1115 BROADWAY, NEW YORK, NY 10010-3450
(917) 960-3061
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
020719
NY
103TC0700X
Clinical Psychologist
P90940
NY
Other
Enumeration date
04/22/2014
Last updated
03/17/2018
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