Provider Demographics
NPI:1336321660
Name:DR DANIEL GALVIN DO PLLC
Entity Type:Organization
Organization Name:DR DANIEL GALVIN DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:GALVIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-674-0608
Mailing Address - Street 1:10 MEDICAL PLZ
Mailing Address - Street 2:SUITE 302
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2193
Mailing Address - Country:US
Mailing Address - Phone:516-674-0608
Mailing Address - Fax:
Practice Address - Street 1:10 MEDICAL PLZ
Practice Address - Street 2:SUITE 302
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2193
Practice Address - Country:US
Practice Address - Phone:516-674-0608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY175996208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01443425Medicaid
F69482Medicare UPIN