Provider Demographics
NPI:1508936717
Name:SIEGEL, GALIA D (PHD)
Entity Type:Individual
Prefix:DR
First Name:GALIA
Middle Name:D
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:900 W 190TH ST
Mailing Address - Street 2:APT 3G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-3633
Mailing Address - Country:US
Mailing Address - Phone:718-781-6991
Mailing Address - Fax:718-920-6538
Practice Address - Street 1:MMC - DEPT. OF PSYCHIATRY
Practice Address - Street 2:111 E. 210TH STREET
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-6105
Practice Address - Fax:718-920-6538
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015684103TC0700X, 103T00000X
NJ35SI00432100103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist