Provider Demographics
NPI:1932093424
Name:GALLAGHER, ROBERT T
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:T
Last Name:GALLAGHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29565 DORCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-5048
Mailing Address - Country:US
Mailing Address - Phone:440-309-3217
Mailing Address - Fax:
Practice Address - Street 1:29565 DORCHESTER DR
Practice Address - Street 2:
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-5048
Practice Address - Country:US
Practice Address - Phone:440-309-3217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-07
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant