Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | TUV4403 | NY |
NPI | 1003893587 |
---|---|
Provider Name | Mr. Gary A Galante |
First Address | Glen Cove, NY 11542 |
Second Address | Glen Cove, NY 11542 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2005 |
Last Update Date | 10/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01013450 | (05) | NY |
T49050 | (02) |