1285939900 NPI number — MS. CHERYL ANN GALATIAN PA-C

Table of content: MS. CHERYL ANN GALATIAN PA-C (NPI 1285939900)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285939900 NPI number — MS. CHERYL ANN GALATIAN PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GALATIAN
Provider First Name:
CHERYL
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FLYNN
Provider Other First Name:
CHERYL
Provider Other Middle Name:
G
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PA-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1285939900
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
600 HOSPITAL DR STE 10A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLYDE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28721-8024
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-452-2320
Provider Business Mailing Address Fax Number:
828-456-4707

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 HOSPITAL DRIVE
Provider Second Line Business Practice Location Address:
SUITE 10A
Provider Business Practice Location Address City Name:
CLYDE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28721
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-452-2320
Provider Business Practice Location Address Fax Number:
828-456-4707
Provider Enumeration Date:
01/12/2011

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: 363A00000X , with the licence number:  PA001253 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , with the licence number: 0010-02649 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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