Provider Demographics
NPI:1013076546
Name:GALLO, STEPHEN J (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:J
Last Name:GALLO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 WASON AVENUE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1119
Mailing Address - Country:US
Mailing Address - Phone:413-241-2100
Mailing Address - Fax:413-735-1986
Practice Address - Street 1:100 WASON AVENUE
Practice Address - Street 2:SUITE 120
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1119
Practice Address - Country:US
Practice Address - Phone:413-241-2100
Practice Address - Fax:413-735-1986
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2010-06-17
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Provider Licenses
StateLicense IDTaxonomies
MA156984208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology