Provider Demographics
NPI:1043476740
Name:GALLINARO, PHILIP MICHAEL
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:MICHAEL
Last Name:GALLINARO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9912 N 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345-8314
Mailing Address - Country:US
Mailing Address - Phone:602-885-7603
Mailing Address - Fax:623-412-0367
Practice Address - Street 1:9912 N 87TH AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-8314
Practice Address - Country:US
Practice Address - Phone:602-885-7603
Practice Address - Fax:623-412-0367
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)