Provider Demographics
NPI:1922819630
Name:GALLIVAN, HANNAH JULIA (RD)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:JULIA
Last Name:GALLIVAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 MAIN ST
Mailing Address - Street 2:FL. 5
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1009
Mailing Address - Country:US
Mailing Address - Phone:716-323-0225
Mailing Address - Fax:716-323-0293
Practice Address - Street 1:1001 MAIN ST
Practice Address - Street 2:FL. 4
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1009
Practice Address - Country:US
Practice Address - Phone:716-323-0170
Practice Address - Fax:716-323-0297
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered