Provider Demographics
NPI:1841435682
Name:GALLANO, MICHAEL OLARIO (PT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:OLARIO
Last Name:GALLANO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1320
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009
Mailing Address - Country:US
Mailing Address - Phone:917-669-8104
Mailing Address - Fax:212-475-0606
Practice Address - Street 1:347 EAST 14TH ST.
Practice Address - Street 2:#4-R
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009
Practice Address - Country:US
Practice Address - Phone:917-669-8104
Practice Address - Fax:212-475-0606
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024305-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist