MEDICARE: FRIENDS & FAMILY PRACTICE, PA

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	207Q00000X	Family Medicine Physician	2001107039	DE

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DF7727	OTHER	DE	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1790878049
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRIENDS & FAMILY PRACTICE, PA

Provider Business Mailing Address
First Line	:	35141 ATLANTIC AVE
Second Line	:	UNIT 1
City	:	MILLVILLE
State	:	DE
Zip	:	19967-6954
Country	:	US
Telephone Number	:	302-537-3740
Fax Number	:	302-537-3744

Provider Business Practice Location Address
First Line	:	35141 ATLANTIC AVE
Second Line	:	UNIT 1
City	:	MILLVILLE
State	:	DE
Zip	:	19967-6954
Country	:	US
Telephone Number	:	302-537-3740
Fax Number	:	302-537-3744

Authorized Official
Title or Position	:	OWNER
Name	:	KIMBERLY GALLAGHER
Credential	:	M.D,
Telephone Number	:	302-537-3740

Provider Enumeration Date	:	10/01/2006
Last Update Date	:	05/08/2013

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Directions to “FRIENDS & FAMILY PRACTICE, PA ” Practice Location

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