Provider Demographics
NPI:1255332573
Name:BLOCK-GALARZA, JESSIE AYLEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSIE
Middle Name:AYLEEN
Last Name:BLOCK-GALARZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:47 NEW SCOTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3412
Mailing Address - Country:US
Mailing Address - Phone:518-262-5185
Mailing Address - Fax:518-262-6303
Practice Address - Street 1:47 NEW SCOTLAND AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3412
Practice Address - Country:US
Practice Address - Phone:518-262-5185
Practice Address - Fax:518-262-6303
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208837207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01820988Medicaid
NYDD6739Medicare ID - Type Unspecified
NY01820988Medicaid