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NPI Code Detail

MEDICARE: MRS. ANGELINE FLORENCE GALLA O.T.R

MEDICARE: MRS. ANGELINE FLORENCE GALLA O.T.R
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOC012285PA

General Provider Information

NPI Number : 1093148660
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANGELINE FLORENCE GALLA O.T.R
Provider Business Mailing Address
First Line : 865 N 26TH ST # 2
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19130-1823
Country : US
Telephone Number : 310-428-4746
Fax Number :
Provider Business Practice Location Address
First Line : 6445 GERMANTOWN AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19119-2345
Country : US
Telephone Number : 215-438-5268
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2013
Last Update Date : 08/18/2013

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