Healthcare Provider Details

I. General information

NPI: 1700454410
Provider Name (Legal Business Name): HANNAH GALVIN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2021
Last Update Date: 07/10/2022
Certification Date: 07/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 BROADWAY
CAMDEN NJ
08103-1253
US

IV. Provider business mailing address

430 W BROWNING RD APT Y11
BELLMAWR NJ
08031-1975
US

V. Phone/Fax

Practice location:
  • Phone: 856-365-3519
  • Fax:
Mailing address:
  • Phone: 267-424-9685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number026672
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: