Provider Demographics
NPI:1710313689
Name:NESTE GALLISA, KATERINA (MD)
Entity Type:Individual
Prefix:MISS
First Name:KATERINA
Middle Name:
Last Name:NESTE GALLISA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9910 FRANKLIN SQUARE DR STE 2110
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4902
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:410-933-1390
Practice Address - Street 1:4940 EASTERN AVE RM 588
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224
Practice Address - Country:US
Practice Address - Phone:410-550-0942
Practice Address - Fax:410-550-0443
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR29505202C00000X
MDD85192207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical Examiner