Provider Demographics
NPI:1104928118
Name:GALLAGHER, CECILIA LIWAG (PT)
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:LIWAG
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CECILIA
Other - Middle Name:PINEDA
Other - Last Name:LIWAG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:13 CEDAR ST.
Mailing Address - Street 2:
Mailing Address - City:HASTINGS-ON-HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706
Mailing Address - Country:US
Mailing Address - Phone:914-478-3983
Mailing Address - Fax:
Practice Address - Street 1:311 WEST 43RD ST.
Practice Address - Street 2:#405
Practice Address - City:NYC
Practice Address - State:NY
Practice Address - Zip Code:10036
Practice Address - Country:US
Practice Address - Phone:212-245-7278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009814225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5405293OtherCIGNA PPO PAR
NY7603604OtherAETNA NON-PAR
NY12068039OtherMULTIPLAN PAR