Gallivan, Kathleen Holly

Gallivan, Kathleen Holly is an individual health care provider with primary practice located at 100 Tradecenter Suite 750, Woburn MA 01801-1851. She recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as her primary health care specialty. Gallivan, Kathleen Holly can be contacted via phone (781) 937-3001.

Contact Information

Primary practice address
100 Tradecenter Suite 750 Woburn MA 01801-1851
Phone: (781) 937-3001
Fax: (781) 305-2779
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 204711 Massachusetts

Profile Details

NPI number 1427056225
LBN Legal business name Gallivan, Kathleen Holly
Credentials MD,MPH,FACS
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Feb 25th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427056225 NPPES
Massachusetts MEDICAID 0109100

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