1144721424 NPI number — DR. CAITLIN ANNE GALLAGHER MD

Table of content: DR. CAITLIN ANNE GALLAGHER MD (NPI 1144721424)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144721424 NPI number — DR. CAITLIN ANNE GALLAGHER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GALLAGHER
Provider First Name:
CAITLIN
Provider Middle Name:
ANNE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144721424
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/22/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
204-221 ADELAIDE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTHAMPTON
Provider Business Mailing Address State Name:
ONTARIO
Provider Business Mailing Address Postal Code:
020
Provider Business Mailing Address Country Code:
CA
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
339 WINDERMERE RD
Provider Second Line Business Practice Location Address:
UNIVERSITY HOSPITAL DEPARTMENT OF ANESTHESIA
Provider Business Practice Location Address City Name:
LONDON
Provider Business Practice Location Address State Name:
ONTARIO
Provider Business Practice Location Address Postal Code:
N6A5A5
Provider Business Practice Location Address Country Code:
CV
Provider Business Practice Location Address Telephone Number:
519-685-8500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/22/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  100275 , registered in the state of ZZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)