Provider Demographics
NPI:1790037307
Name:GALIARDO, BRIANA (RD)
Entity Type:Individual
Prefix:MS
First Name:BRIANA
Middle Name:
Last Name:GALIARDO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 GRASSMERE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11769-2323
Mailing Address - Country:US
Mailing Address - Phone:631-235-3611
Mailing Address - Fax:
Practice Address - Street 1:224 GRASSMERE AVE
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:NY
Practice Address - Zip Code:11769-2323
Practice Address - Country:US
Practice Address - Phone:631-235-3611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1082558133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered