Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QG0300X | Family Doctor - Geriatric Medicine | 54654 | WI |
N | 207QG0300X | Family Doctor - Geriatric Medicine | MT189909 | PA |
Y | 207RG0300X | Geriatric Medicine | 54654 | WI |
NPI | 1255518437 |
---|---|
Provider Name | Galia Paganelli |
First Address | La Crosse, WI 54601-8806 |
Second Address | La Crosse, WI 54601-8806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2008 |
Last Update Date | 09/09/2014 |