Provider Demographics
NPI:1417194101
Name:GALLAGHER, PAMELA LYNNE (OTR/L, CHT)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:LYNNE
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 TILTON RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225-1265
Mailing Address - Country:US
Mailing Address - Phone:609-645-0505
Mailing Address - Fax:609-645-7437
Practice Address - Street 1:801 TILTON RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1265
Practice Address - Country:US
Practice Address - Phone:609-645-0505
Practice Address - Fax:609-645-7437
Is Sole Proprietor?:No
Enumeration Date:2009-01-16
Last Update Date:2020-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00127600225XH1200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist