MEDICARE: ABBEY LEWIS GALLIEN M.D.

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
1	208000000X	Pediatrics Physician	09851R	LA

General Provider Information

NPI Number	:	1265472856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABBEY LEWIS GALLIEN M.D.

Provider Business Mailing Address
First Line	:	59101 AMBER ST
Second Line	:
City	:	SLIDELL
State	:	LA
Zip	:	70461-3717
Country	:	US
Telephone Number	:	985-646-1580
Fax Number	:	985-646-1579

Provider Business Practice Location Address
First Line	:	42124 VETERANS AVE
Second Line	:	SUITE A
City	:	HAMMOND
State	:	LA
Zip	:	70403-1427
Country	:	US
Telephone Number	:	985-543-0565
Fax Number	:	985-543-0567

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	01/05/2015

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