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Individual

MS. KATHLEEN M. GALLAWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
130 CENTER WAY, CORNING, NY 14830-2255
(607) 936-9971
(607) 936-2600
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
369422-1
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
F380308-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01568538
NY
01
500001501
RR MEDICARE PIN
NY
01
CC8362
RR MEDICARE GROUP
NY
Enumeration date
03/22/2006
Last updated
03/20/2021
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