Provider Demographics
NPI:1487182655
Name:GALLAGHER, COURTNEY LYNN (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:LYNN
Last Name:GALLAGHER
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Gender:F
Credentials:MD, MPH
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Mailing Address - Street 1:3401 CIVIC CENTER BOULEVARD
Mailing Address - Street 2:9NW, ROOM 55
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4399
Mailing Address - Country:US
Mailing Address - Phone:215-590-1220
Mailing Address - Fax:
Practice Address - Street 1:3401 CIVIC CENTER BLVD RM 55
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4319
Practice Address - Country:US
Practice Address - Phone:215-590-1220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT212727208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics