Provider Demographics
NPI:1356454078
Name:GALANT, JOHN MITCHELL (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MITCHELL
Last Name:GALANT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-1041
Mailing Address - Country:US
Mailing Address - Phone:201-568-2100
Mailing Address - Fax:201-568-9736
Practice Address - Street 1:285 COUNTY RD
Practice Address - Street 2:
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670-1041
Practice Address - Country:US
Practice Address - Phone:201-568-2100
Practice Address - Fax:201-568-9736
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD0002196213E00000X
NJMD00002196213E00000X, 213EP1101X, 213ES0000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ611298Medicare ID - Type Unspecified
NJ6174920001Medicare NSC
NJU43304Medicare UPIN