1518992643 NPI number — MS. ILENE ANN GALINSKY ADT NURSE PRACTIONER

Table of content: MS. ILENE ANN GALINSKY ADT NURSE PRACTIONER (NPI 1518992643)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518992643 NPI number — MS. ILENE ANN GALINSKY ADT NURSE PRACTIONER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GALINSKY
Provider First Name:
ILENE
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ADT NURSE PRACTIONER
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:
1518992643
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
302 VERMONT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST ROXBURY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02132
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-469-5399
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
44 BINNEY ST # DL189B
Provider Second Line Business Practice Location Address:
DANA FARBER CANCER INSTITUTE
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02115-6013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-632-3902
Provider Business Practice Location Address Fax Number:
617-632-6389
Provider Enumeration Date:
07/11/2006

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: 207RH0003X , with the licence number:  189626 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 189626 . This is a "BOARD OF NURSING" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 038391121674070 . This is a "ANCC" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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