Individual
MRS. SUSAN D GALLARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
900 WALNUT STREET, THOMAS JEFFERSON UNIVERSITY PHYSICIANS SUITE 200, PHILADELPHIA, PA 19107
(215) 955-6939
(215) 503-2990
Mailing address
900 WALNUT STREET, 2ND FLOOR, PHILADELPHIA, PA 19107
(215) 955-7000
(215) 923-3504
Taxonomy
Speciality
Code
Description
License number
State
163WN0800X
Neuroscience Registered Nurse
SP010847
PA
363L00000X
Nurse Practitioner
Primary
SP010847
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102886280
—
PA
Enumeration date
11/02/2010
Last updated
04/14/2014
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