Provider Demographics
NPI:1245576032
Name:GALEGA, EMMANUEL G (CHW)
Entity Type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:G
Last Name:GALEGA
Suffix:
Gender:M
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 GREEN CRESCENT CT
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3098
Mailing Address - Country:US
Mailing Address - Phone:240-716-0608
Mailing Address - Fax:
Practice Address - Street 1:6104 BREEZEWOOD DR
Practice Address - Street 2:APT 201
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-1148
Practice Address - Country:US
Practice Address - Phone:240-965-0608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-24
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC172V00000X
374U00000X, 172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No374U00000XNursing Service Related ProvidersHome Health Aide