Provider Demographics
NPI:1427282292
Name:GALLAGHER, KRISTIN M (PT)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:M
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:M
Other - Last Name:TOMMELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:109 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-2538
Mailing Address - Country:US
Mailing Address - Phone:914-494-4524
Mailing Address - Fax:
Practice Address - Street 1:COMMUNITY LOCATIONS
Practice Address - Street 2:WESTCHESTER COUNTY
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520
Practice Address - Country:US
Practice Address - Phone:914-494-4524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-08
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPT-022384-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics