Provider Demographics
NPI:1114019403
Name:GALLELLI, ELIZABETH ANN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANN
Last Name:GALLELLI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11085 LITTLE PATUXENT PARKWAY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044
Mailing Address - Country:US
Mailing Address - Phone:410-884-4111
Mailing Address - Fax:410-884-4113
Practice Address - Street 1:10700 CHARTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3629
Practice Address - Country:US
Practice Address - Phone:410-884-4111
Practice Address - Fax:410-884-4113
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD21991225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist