Provider Demographics
NPI:1033986377
Name:GALARZA-MODICA, VERONICA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:
Last Name:GALARZA-MODICA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:
Other - Last Name:GALARZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:158 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-1701
Mailing Address - Country:US
Mailing Address - Phone:516-526-6144
Mailing Address - Fax:
Practice Address - Street 1:158 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-1701
Practice Address - Country:US
Practice Address - Phone:516-526-6144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-06
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY598474363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily