Provider Demographics
NPI:1114694932
Name:GALVEZ, NATALIE FERNANDA (NP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:FERNANDA
Last Name:GALVEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3078 37TH ST APT 1R
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-3816
Mailing Address - Country:US
Mailing Address - Phone:917-387-5736
Mailing Address - Fax:
Practice Address - Street 1:9932 66TH RD LBBY
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4462
Practice Address - Country:US
Practice Address - Phone:718-896-4090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-28
Last Update Date:2021-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY714110363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily