Provider Demographics
NPI:1316364144
Name:GALAKTIONOVA, DINA (DO)
Entity Type:Individual
Prefix:DR
First Name:DINA
Middle Name:
Last Name:GALAKTIONOVA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 MAIN ST
Mailing Address - Street 2:DEPARTMENT OF SURGERY, TRAUMA DIVISION
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503-2621
Mailing Address - Country:US
Mailing Address - Phone:973-754-2490
Mailing Address - Fax:973-754-3599
Practice Address - Street 1:703 MAIN ST
Practice Address - Street 2:DEPARTMENT OF SURGERY, TRAUMA DIVISION
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-2621
Practice Address - Country:US
Practice Address - Phone:973-754-2490
Practice Address - Fax:973-754-3599
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB096750002086S0102X, 2086S0127X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery