Provider Demographics
NPI:1639142334
Name:GALLERANI, JULIANNE R (OD)
Entity Type:Individual
Prefix:DR
First Name:JULIANNE
Middle Name:R
Last Name:GALLERANI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:656 SPRINGFIELD ST
Mailing Address - Street 2:
Mailing Address - City:FEEDING HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:01030-2130
Mailing Address - Country:US
Mailing Address - Phone:413-789-2106
Mailing Address - Fax:413-786-6918
Practice Address - Street 1:656 SPRINGFIELD ST
Practice Address - Street 2:
Practice Address - City:FEEDING HILLS
Practice Address - State:MA
Practice Address - Zip Code:01030-2130
Practice Address - Country:US
Practice Address - Phone:413-789-2106
Practice Address - Fax:413-786-6918
Is Sole Proprietor?:No
Enumeration Date:2006-02-12
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3119152W00000X, 152WC0802X, 152WP0200X, 152WS0006X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA15792OtherHEALTHNEWENGLAND
MAS016443OtherCHAMPUS
MA0352624Medicaid
MA310019OtherCONNECTICARE
MAW15626OtherBLUECROSSBLUESHIELD
MA15792OtherHEALTHNEWENGLAND
MA215758Medicare ID - Type Unspecified