Provider Demographics
NPI:1790842730
Name:GALLAGHER, SEAN PADRIC (PT)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:PADRIC
Last Name:GALLAGHER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:HASTINGS ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706-3905
Mailing Address - Country:US
Mailing Address - Phone:212-245-7278
Mailing Address - Fax:212-245-7461
Practice Address - Street 1:330 W 42ND ST
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-6902
Practice Address - Country:US
Practice Address - Phone:212-245-7278
Practice Address - Fax:212-245-7461
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009366-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0107301OtherHEALTHNET ORTHONET
NY4417349OtherAETNA NON-PAR
NYP2166797OtherOXFORD
NYQ63523OtherEBCBS HMO
NY12067507OtherMULTIPLAN
NY2C0813OtherHEALTHNET
NY77A0121OtherABC HEALTHPLAN
NY4261314OtherCIGNA PPO PAR
NY4261314OtherCIGNA PPO PAR