Provider Demographics
NPI:1558643445
Name:GALLUCCIO, YAMILLETH (BILINGUAL-TSHH)
Entity Type:Individual
Prefix:MRS
First Name:YAMILLETH
Middle Name:
Last Name:GALLUCCIO
Suffix:
Gender:F
Credentials:BILINGUAL-TSHH
Other - Prefix:MISS
Other - First Name:YAMILLETH
Other - Middle Name:
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:40 89TH ST
Mailing Address - Street 2:APT 2G
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-5551
Mailing Address - Country:US
Mailing Address - Phone:718-290-6999
Mailing Address - Fax:
Practice Address - Street 1:454 BAY RIDGE AVE
Practice Address - Street 2:GROUND LEVEL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-5906
Practice Address - Country:US
Practice Address - Phone:718-333-5665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist