Provider Demographics
NPI:1376575662
Name:NORWOOD-GALLOWAY, DELLIS A (MD)
Entity Type:Individual
Prefix:
First Name:DELLIS
Middle Name:A
Last Name:NORWOOD-GALLOWAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 PONDFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-3809
Mailing Address - Country:US
Mailing Address - Phone:914-337-4986
Mailing Address - Fax:
Practice Address - Street 1:77 PONDFIELD RD
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-3809
Practice Address - Country:US
Practice Address - Phone:914-337-4986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1657751207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
32E931Medicare ID - Type Unspecified
NYE56300Medicare UPIN