Provider Demographics
NPI:1043618044
Name:GALLAGHER, CHRISTINA M (PT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:M
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:CHRISTINA
Other - Middle Name:M
Other - Last Name:CUZZOCREA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:66 KAIHOLU PL
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1951
Mailing Address - Country:US
Mailing Address - Phone:808-781-6561
Mailing Address - Fax:888-806-1531
Practice Address - Street 1:122 ONEAWA ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2524
Practice Address - Country:US
Practice Address - Phone:808-263-4263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1721225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist