Basic Information
Provider Information
NPI: 1386935187
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GALE
FirstName: ELIZABETH
MiddleName: MILLETT
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5 ALUMNI DR
Address2:  
City: EXETER
State: NH
PostalCode: 038332128
CountryCode: US
TelephoneNumber: 6035807525
FaxNumber: 6035807542
Practice Location
Address1: 5 ALUMNI DR
Address2:  
City: EXETER
State: NH
PostalCode: 038332128
CountryCode: US
TelephoneNumber: 6035807525
FaxNumber: 6035807525
Other Information
ProviderEnumerationDate: 04/27/2011
LastUpdateDate: 03/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X21218NHY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


Home