Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 044660 | NY |
NPI | 1013032226 |
---|---|
Provider Name | Dr. Joseph L Gallo |
First Address | Orchard Park, NY 14127-2401 |
Second Address | Orchard Park, NY 14127-2401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 08/08/2016 |