Provider Demographics
NPI:1629695325
Name:GALLAGHER, ANDREW EDWARD (AUD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:EDWARD
Last Name:GALLAGHER
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 RIVERPATH DR APT 26
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-3897
Mailing Address - Country:US
Mailing Address - Phone:561-779-4836
Mailing Address - Fax:
Practice Address - Street 1:600 WORCESTER RD LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-5303
Practice Address - Country:US
Practice Address - Phone:508-872-6679
Practice Address - Fax:508-879-8100
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4811231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist