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NPI Code Detail

MEDICARE: DR. SHANNON CHRISTINE THEOBALD-GALGANO MD

MEDICARE: DR. SHANNON CHRISTINE THEOBALD-GALGANO MD
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
1207V00000XObstetrics & Gynecology PhysicianMD476823PA

General Provider Information

NPI Number : 1730670159
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHANNON CHRISTINE THEOBALD-GALGANO MD
Provider Business Mailing Address
First Line : 4051 FREEMANSBURG AVE
Second Line :
City : EASTON
State : PA
Zip : 18045-5596
Country : US
Telephone Number : 484-503-7474
Fax Number :
Provider Business Practice Location Address
First Line : 4051 FREEMANSBURG AVE
Second Line :
City : EASTON
State : PA
Zip : 18045-5596
Country : US
Telephone Number : 484-503-7474
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2018
Last Update Date : 12/08/2025

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