Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QG0300X | Family Doctor - Geriatric Medicine | 25MB04692900 | NJ |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | OS007995L | PA |
NPI | 1336140979 |
---|---|
Provider Name | Katherine E. Galluzzi |
First Address | Philadelphia, PA 19131-1626 |
Second Address | Philadelphia, PA 19131-1626 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2005 |
Last Update Date | 25/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001091860 | (05) | PA |
C58138 | (02) |