Provider Demographics
NPI:1508095472
Name:GALLA, ASHLEY ROSE (PHARMD, BCACP)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:ROSE
Last Name:GALLA
Suffix:
Gender:F
Credentials:PHARMD, BCACP
Other - Prefix:DR
Other - First Name:ASHLEY
Other - Middle Name:ROSE
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, BCACP
Mailing Address - Street 1:27005 76TH AVE
Mailing Address - Street 2:DEPARTMENT OF PHARMACY
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1402
Mailing Address - Country:US
Mailing Address - Phone:203-592-5240
Mailing Address - Fax:
Practice Address - Street 1:27005 76TH AVE
Practice Address - Street 2:DEPARTMENT OF PHARMACY
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1402
Practice Address - Country:US
Practice Address - Phone:203-592-5240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0011324183500000X
NY055082-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist