Provider Demographics
NPI:1891348660
Name:GALLO, SARAH OLSEN (NP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:OLSEN
Last Name:GALLO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:DANIELLE
Other - Last Name:OLSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:301 SAINT PAUL PL STE 501
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-2165
Mailing Address - Country:US
Mailing Address - Phone:410-332-9797
Mailing Address - Fax:410-332-9789
Practice Address - Street 1:301 SAINT PAUL PL
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2165
Practice Address - Country:US
Practice Address - Phone:410-332-9797
Practice Address - Fax:410-332-9789
Is Sole Proprietor?:No
Enumeration Date:2019-07-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR225579363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal