1972806222 NPI number — MS. PATRICIA M GALANIS CRNP

Table of content: MS. PATRICIA M GALANIS CRNP (NPI 1972806222)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972806222 NPI number — MS. PATRICIA M GALANIS CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GALANIS
Provider First Name:
PATRICIA
Provider Middle Name:
M
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972806222
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/20/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 S 11TH ST
Provider Second Line Business Mailing Address:
SUITE 4240
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19107-4824
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-955-8874
Provider Business Mailing Address Fax Number:
215-955-2340

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
132 SOUTH 10TH STREET
Provider Second Line Business Practice Location Address:
SUITE 1147 THOMPSON BUILDING
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19107-4824
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-503-1155
Provider Business Practice Location Address Fax Number:
215-503-3829
Provider Enumeration Date:
12/08/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  SP011123 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 103069646 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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