Provider Demographics
NPI:1669652038
Name:GALGANO, WENDY WHITNEY (RPH)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:WHITNEY
Last Name:GALGANO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:NY
Mailing Address - Zip Code:14512-9507
Mailing Address - Country:US
Mailing Address - Phone:585-374-6966
Mailing Address - Fax:
Practice Address - Street 1:400 W MORRIS ST
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:NY
Practice Address - Zip Code:14810-1039
Practice Address - Country:US
Practice Address - Phone:607-776-3320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040434-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY040434-1Medicaid