Provider Demographics
NPI:1669425815
Name:GALLEN, ROBERT T (PHD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:T
Last Name:GALLEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:ASPINWALL
Mailing Address - State:PA
Mailing Address - Zip Code:15215-3020
Mailing Address - Country:US
Mailing Address - Phone:412-780-0462
Mailing Address - Fax:412-782-0596
Practice Address - Street 1:305 CENTER AVE
Practice Address - Street 2:
Practice Address - City:ASPINWALL
Practice Address - State:PA
Practice Address - Zip Code:15215-3020
Practice Address - Country:US
Practice Address - Phone:412-780-0462
Practice Address - Fax:412-782-0596
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS009187L103TC0700X
103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1397783Medicare UPIN