Healthcare Provider Details

I. General information

NPI: 1730331927
Provider Name (Legal Business Name): PATTI DEFILIPPS GALLEHER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 07/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 S POTOMAC ST SUITE 130
AURORA CO
80012-5455
US

IV. Provider business mailing address

9197 GRANT ST SUITE 100
THORNTON CO
80229-4361
US

V. Phone/Fax

Practice location:
  • Phone: 303-360-0095
  • Fax: 303-360-8088
Mailing address:
  • Phone: 303-450-3690
  • Fax: 303-962-1511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number534
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: