Provider Demographics
NPI:1376629477
Name:GALANTI, PATRICIA (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:GALANTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9669 E 146TH ST
Practice Address - Street 2:SUITE 250
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-5005
Practice Address - Country:US
Practice Address - Phone:317-621-9926
Practice Address - Fax:317-621-9676
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01057937207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200454820Medicaid
INP01157039OtherRR MEDICARE PTAN
INM400037735Medicare PIN
INI42995Medicare UPIN
P00317197Medicare PIN
INM400037737Medicare PIN
IN151560JJMedicare PIN
INM400037738Medicare PIN
IN200454820Medicaid
INM400037743Medicare PIN
INP01157039OtherRR MEDICARE PTAN
INM400037741Medicare PIN