Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 236244 | NY |
Y | 208200000X | Surgeon | 236244 | NY |
Y | 208600000X | Surgeon | 236244 | NY |
NPI | 1508956400 |
---|---|
Provider Name | Dr. Michael Haden Gallichio |
First Address | Albany, NY 12209-1756 |
Second Address | Albany, NY 12209-1756 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 01/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G52970 | (02) | NY |