Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OEG001384 | PA |
NPI | 1003856303 |
---|---|
Provider Name | Gregory Gallagher |
First Address | Pittsburgh, PA 15237 |
Second Address | Pittsburgh, PA 15237 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 08/07/2007 |