Provider Demographics
NPI:1114284544
Name:GALLO, ANDREA (OD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:GALLO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 ROCKLAND RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-3648
Mailing Address - Country:US
Mailing Address - Phone:302-651-4407
Mailing Address - Fax:
Practice Address - Street 1:1801 ROCKLAND RD
Practice Address - Street 2:NEMOURS SENIOR CARE OPHTHALMOLOGY CLINIC
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3648
Practice Address - Country:US
Practice Address - Phone:302-651-4407
Practice Address - Fax:302-651-4457
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEI3-0001357152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3910908000OtherBCBS IBC
PA002792476OtherBCBS HIGHMARK
PA102878493Medicaid
PA3910908000OtherBCBS IBC