Provider Demographics
NPI:1558617480
Name:GALOOSHIAN, LIYA (MD)
Entity Type:Individual
Prefix:MRS
First Name:LIYA
Middle Name:
Last Name:GALOOSHIAN
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 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-339-2025
Mailing Address - Fax:717-339-2011
Practice Address - Street 1:147 GETTYS ST
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2534
Practice Address - Country:US
Practice Address - Phone:717-339-2025
Practice Address - Fax:717-339-2011
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD455457207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103044351Medicaid
PAPO1747097OtherRAILROAD
PA103044351Medicaid