Provider Demographics
NPI:1114689270
Name:GALLO, STEFANIE ANN
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:ANN
Last Name:GALLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 SHEFFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-1617
Mailing Address - Country:US
Mailing Address - Phone:401-525-0577
Mailing Address - Fax:
Practice Address - Street 1:41 SHEFFIELD AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-1617
Practice Address - Country:US
Practice Address - Phone:401-525-0577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula