Healthcare Provider Details

I. General information

NPI: 1265472856
Provider Name (Legal Business Name): ABBEY LEWIS GALLIEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 01/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42124 VETERANS AVE SUITE A
HAMMOND LA
70403-1427
US

IV. Provider business mailing address

59101 AMBER ST
SLIDELL LA
70461-3717
US

V. Phone/Fax

Practice location:
  • Phone: 985-543-0565
  • Fax: 985-543-0567
Mailing address:
  • Phone: 985-646-1580
  • Fax: 985-646-1579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number09851R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: