Provider Demographics
NPI:1083795751
Name:GALIBERT, LOU-ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:LOU-ANN
Middle Name:
Last Name:GALIBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-0027
Mailing Address - Country:US
Mailing Address - Phone:914-659-0302
Mailing Address - Fax:
Practice Address - Street 1:311 NORTH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2217
Practice Address - Country:US
Practice Address - Phone:914-659-0302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203337208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01752854Medicaid
NY01752854Medicaid
NY67L791Medicare ID - Type Unspecified