Provider Demographics
NPI:1629158811
Name:GALIT SHALOM-CRAIG PSY D P A
Entity Type:Organization
Organization Name:GALIT SHALOM-CRAIG PSY D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GALIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SHALOM-CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:772-713-8716
Mailing Address - Street 1:655 CAMELIA LN
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-1841
Mailing Address - Country:US
Mailing Address - Phone:772-713-8716
Mailing Address - Fax:772-257-5653
Practice Address - Street 1:655 CAMELIA LN
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32963-1841
Practice Address - Country:US
Practice Address - Phone:772-713-8716
Practice Address - Fax:772-257-5653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 6510103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73026OtherBCBS PROVIDER NUMBER
FLK4409Medicare PIN