Provider Demographics
NPI:1750789442
Name:GALIS, EMILIO
Entity type:Individual
Prefix:
First Name:EMILIO
Middle Name:
Last Name:GALIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 HELEN AVE
Mailing Address - Street 2:
Mailing Address - City:MONESSEN
Mailing Address - State:PA
Mailing Address - Zip Code:15062-2411
Mailing Address - Country:US
Mailing Address - Phone:412-997-6405
Mailing Address - Fax:
Practice Address - Street 1:638 ROSTRAVER RD STE 102
Practice Address - Street 2:
Practice Address - City:ROSTRAVER TWP
Practice Address - State:PA
Practice Address - Zip Code:15012-1967
Practice Address - Country:US
Practice Address - Phone:412-997-6405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-11
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT024068225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty