Provider Demographics
NPI:1295424703
Name:GALLO, ASHLEE MARIE (MS)
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:MARIE
Last Name:GALLO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 REGIS DR
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-1423
Mailing Address - Country:US
Mailing Address - Phone:646-427-0608
Mailing Address - Fax:
Practice Address - Street 1:179 REGIS DR
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-1423
Practice Address - Country:US
Practice Address - Phone:646-427-0608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY885986142252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency