Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 215872 | NY |
NPI | 1245330885 |
---|---|
Provider Name | Dr. Jessica B Gallina |
First Address | New York, NY 10019 |
Second Address | New York, NY 10019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2006 |
Last Update Date | 19/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I05422 | (02) | NY |