Individual
KATHLEEN HOLLY GALLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD,MPH,FACS
Contact information
Practice address
100 TRADECENTER, SUITE 750, WOBURN, MA 01801-1851
(781) 937-3001
(781) 305-2779
Mailing address
100 TRADECENTER, SUITE 750, WOBURN, MA 01801-1851
(781) 937-3001
(781) 305-2779
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
204711
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0109100
—
MA
Enumeration date
07/14/2005
Last updated
02/25/2014
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