Provider Demographics
NPI:1568436319
Name:GALIZI, MARLENE D (MD)
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:D
Last Name:GALIZI
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 1:141 S CENTRAL AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-2319
Mailing Address - Country:US
Mailing Address - Phone:914-713-3228
Mailing Address - Fax:914-713-3231
Practice Address - Street 1:141 S CENTRAL AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-2319
Practice Address - Country:US
Practice Address - Phone:914-713-3228
Practice Address - Fax:914-713-3231
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-16
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183056207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02039265Medicaid
G23303Medicare UPIN
NY02039265Medicaid