Susan D Gallardo, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP010847 Issued in PA

Practice address

900 Walnut Street
Thomas Jefferson University Physicians Suite 200
Philadelphia, PA 19107

Phone

(215) 955-6939

Fax

(215) 503-2990

NPI assigned

Nov 2, 2010

Last updated

Apr 14, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397433600000",
    "number": "1154621449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 WALNUT STREET",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19107",
            "telephone_number": "215-955-7000",
            "fax_number": "215-923-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WALNUT STREET",
            "address_2": "THOMAS JEFFERSON UNIVERSITY PHYSICIANS SUITE 200",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19107",
            "telephone_number": "215-955-6939",
            "fax_number": "215-503-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLARDO",
        "first_name": "SUSAN",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-02",
        "last_updated": "2014-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0800X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neuroscience",
            "state": "PA",
            "license": "SP010847",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP010847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102886280",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Bernadette Gallagher, CRNP
• Steven Gallagher, PT
• Thomas Gallagher
• Thomas Patrick Gallagher, LAT, ATC
• Leslie Gallant, RD
• Michael F Gallaway
• Raegan Galleher
• Gallery Eye Associates, LLC (Designer Eyes)
• Gallery Mall Dental PC
• Karen Galli, D.P.M.

• Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.