Provider Demographics
NPI:1518016112
Name:LEON GALAT, ANGELA MARIA (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIA
Last Name:LEON GALAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:MARIA
Other - Last Name:LAWRENCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:251 WOODLAKE DR SE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-5530
Mailing Address - Country:US
Mailing Address - Phone:507-206-2563
Mailing Address - Fax:507-377-5505
Practice Address - Street 1:251 WOODLAKE DR SE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-5530
Practice Address - Country:US
Practice Address - Phone:507-206-2563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN398212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN096324100Medicaid
MNG 56499Medicare UPIN