Provider Demographics
NPI:1871652727
Name:GALLO, FRANCO (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCO
Middle Name:
Last Name:GALLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 HALLOCK AVENUE
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776
Mailing Address - Country:US
Mailing Address - Phone:631-331-7200
Mailing Address - Fax:631-331-8636
Practice Address - Street 1:931 HALLOCK AVENUE
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776
Practice Address - Country:US
Practice Address - Phone:631-331-7200
Practice Address - Fax:631-331-8636
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182338174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW18451Medicare ID - Type Unspecified
NYF59111Medicare UPIN