Provider Demographics
NPI:1518000165
Name:GALLI, KATHLEEN M (MS, ATC)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:M
Last Name:GALLI
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 BEARDSLEE RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-5107
Mailing Address - Country:US
Mailing Address - Phone:908-281-0818
Mailing Address - Fax:
Practice Address - Street 1:83 ROCKAFELLER RD
Practice Address - Street 2:LOUIS BROWN ATHLETIC CENTER
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-8053
Practice Address - Country:US
Practice Address - Phone:732-445-7747
Practice Address - Fax:732-445-6746
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT000068002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer