Provider Demographics
NPI:1093855702
Name:DUMCHIN, GALINA
Entity Type:Individual
Prefix:
First Name:GALINA
Middle Name:
Last Name:DUMCHIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GALINA
Other - Middle Name:
Other - Last Name:BUKH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:R-PAC
Mailing Address - Street 1:9740 62ND DR
Mailing Address - Street 2:APT 6G,
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1344
Mailing Address - Country:US
Mailing Address - Phone:718-897-1012
Mailing Address - Fax:
Practice Address - Street 1:5141 BROADWAY
Practice Address - Street 2:ROOM 2095
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-1159
Practice Address - Country:US
Practice Address - Phone:212-932-5218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006788363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant