Provider Demographics
NPI:1477535441
Name:GALLAGHER, CATHERINE J
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:J
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14535 JOHN MARSHALL HIGHWAY
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155
Mailing Address - Country:US
Mailing Address - Phone:703-753-0974
Mailing Address - Fax:703-753-9709
Practice Address - Street 1:14535 JOHN MARSHALL HIGHWAY
Practice Address - Street 2:SUITE 203
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155
Practice Address - Country:US
Practice Address - Phone:703-753-0974
Practice Address - Fax:703-753-9709
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305004656225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006540A23Medicare PIN
Q34669Medicare UPIN
VA1477535441Medicare PIN