Provider Demographics
NPI:1003893587
Name:GALANTE, GARY A (OD)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:A
Last Name:GALANTE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 SCHOOL ST
Mailing Address - Street 2:STE 1
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542
Mailing Address - Country:US
Mailing Address - Phone:516-676-4561
Mailing Address - Fax:516-676-4481
Practice Address - Street 1:50 SCHOOL ST
Practice Address - Street 2:STE 1
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542
Practice Address - Country:US
Practice Address - Phone:516-676-4561
Practice Address - Fax:516-676-4481
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV4403152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01013450Medicaid
T49050Medicare UPIN
NY01013450Medicaid