Cornelia Lucia Gallo, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

034522 Issued in CT

Practice address

19 Compo Rd S
Westport, CT 06880-4319

Phone

(203) 226-3134

Fax

(203) 259-4916

NPI assigned

Jun 10, 2007

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1181433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023211653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 BARBARA PL",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068804164",
            "telephone_number": "203-254-3828",
            "fax_number": "203-259-4916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 COMPO RD S",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068804319",
            "telephone_number": "203-226-3134",
            "fax_number": "203-259-4916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLO",
        "first_name": "CORNELIA",
        "middle_name": "LUCIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CT",
            "license": "034522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Genevieve Carino Gacula, MHA, MBA
• James Paul Gadzik, M.D.
• Lindsay Gadzik
• Susan Marie Gaffney, LCSW
• Margaret M Galiani, MD
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• Anita Sandra Galvan-Henkin, M.S.W.
• Galvan-Henkin, LLC
• Jessica Paula Gamache, LBA, BCBA
• Mitchell Seth Gandelman, MD

• All providers in Westport, CT
• Child & Adolescent Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.