Provider Demographics
NPI:1376618041
Name:GALLINARO, ANDREW JOHN (DC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:JOHN
Last Name:GALLINARO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 GILCREAST RD
Mailing Address - Street 2:UNIT 200
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053
Mailing Address - Country:US
Mailing Address - Phone:603-624-6100
Mailing Address - Fax:603-432-3371
Practice Address - Street 1:75 GILCREAST RD
Practice Address - Street 2:UNIT 200
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053
Practice Address - Country:US
Practice Address - Phone:603-624-6100
Practice Address - Fax:603-432-3371
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH6500102111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U88324Medicare UPIN
NHRE6536Medicare ID - Type Unspecified