Basic Information
Provider Information
NPI: 1255349031
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GALLI
FirstName: KAREN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: D.P.M.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3900 WOODLAND AVE
Address2: PODIATRY (112)
City: PHILADELPHIA
State: PA
PostalCode: 191044551
CountryCode: US
TelephoneNumber: 2158235800
FaxNumber: 2158234309
Practice Location
Address1: 3900 WOODLAND AVE
Address2: PODIATRY (112)
City: PHILADELPHIA
State: PA
PostalCode: 191044551
CountryCode: US
TelephoneNumber: 2158235800
FaxNumber: 2158234309
Other Information
ProviderEnumerationDate: 08/04/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
213ES0131XSC003366LPAY Podiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery

No ID Information.


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