Provider Demographics
NPI:1942278486
Name:GALLAGHER, JULIE MAUREEN (PT)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:MAUREEN
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 W SIENKO DR
Mailing Address - Street 2:
Mailing Address - City:HALLSTEAD
Mailing Address - State:PA
Mailing Address - Zip Code:18822-9784
Mailing Address - Country:US
Mailing Address - Phone:570-879-1084
Mailing Address - Fax:
Practice Address - Street 1:16749 STATE ROUTE 706
Practice Address - Street 2:SUITE 6
Practice Address - City:MONTROSE
Practice Address - State:PA
Practice Address - Zip Code:18801-7706
Practice Address - Country:US
Practice Address - Phone:570-278-1101
Practice Address - Fax:570-278-1102
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026910-1225100000X
PAPT012734L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA825514OtherFIRST PRIORITY HEALTH
PA2143769OtherHIGHMARK BLUE SHIELD
PA825514OtherFIRST PRIORITY HEALTH