Provider Demographics
NPI:1063489813
Name:GALANOUDIS, KAREY (PT)
Entity Type:Individual
Prefix:
First Name:KAREY
Middle Name:
Last Name:GALANOUDIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 MONTAUK HWY
Mailing Address - Street 2:
Mailing Address - City:COPIAGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11726-4904
Mailing Address - Country:US
Mailing Address - Phone:631-842-4606
Mailing Address - Fax:631-842-0803
Practice Address - Street 1:1160 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:COPIAGUE
Practice Address - State:NY
Practice Address - Zip Code:11726-4904
Practice Address - Country:US
Practice Address - Phone:631-842-4606
Practice Address - Fax:631-842-0803
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018413-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY900061612OtherMAGNACARE
NY900061612OtherMAGNACARE