Provider Demographics
NPI:1497188346
Name:GALLUCCI, GARY ANDREW (EDD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:ANDREW
Last Name:GALLUCCI
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 ABBEYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-1747
Mailing Address - Country:US
Mailing Address - Phone:412-600-3537
Mailing Address - Fax:
Practice Address - Street 1:450 ABBEYVILLE ROAD
Practice Address - Street 2:SUITE 1419
Practice Address - City:PITTSBURGH
Practice Address - State:OH
Practice Address - Zip Code:44720-2409
Practice Address - Country:US
Practice Address - Phone:412-246-8965
Practice Address - Fax:412-224-4550
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008194L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist