Provider Demographics
NPI:1003950148
Name:GALITZ, DINA L (NP)
Entity Type:Individual
Prefix:MRS
First Name:DINA
Middle Name:L
Last Name:GALITZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:DINA
Other - Middle Name:L
Other - Last Name:GILLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:10314 STRATHMORE HALL ST
Mailing Address - Street 2:APT 401
Mailing Address - City:NORTH BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-6612
Mailing Address - Country:US
Mailing Address - Phone:301-897-0321
Mailing Address - Fax:
Practice Address - Street 1:8600 OLD GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1422
Practice Address - Country:US
Practice Address - Phone:301-896-2654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR173381363LF0000X
FL2805892363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS92116Medicare UPIN