Healthcare Provider Details

I. General information

NPI: 1730477381
Provider Name (Legal Business Name): REKHA GALLA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2011
Last Update Date: 11/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3157 MOUNT MORRIS RD STE 102
WAYNESBURG PA
15370-8155
US

IV. Provider business mailing address

6433 INTERLAKEN DR
MC DONALD PA
15057-3557
US

V. Phone/Fax

Practice location:
  • Phone: 254-702-0257
  • Fax: 877-706-7396
Mailing address:
  • Phone: 724-470-2025
  • Fax: 877-706-7396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberMD441234
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: