Provider Demographics
NPI:1568138428
Name:GALBO, JEFFREY A
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:A
Last Name:GALBO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 BONNIE HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-3752
Mailing Address - Country:US
Mailing Address - Phone:603-204-8099
Mailing Address - Fax:603-518-7448
Practice Address - Street 1:264 S RIVER RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6824
Practice Address - Country:US
Practice Address - Phone:603-204-8099
Practice Address - Fax:603-518-7448
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH107474Medicaid