Provider Demographics
NPI:1689937807
Name:GALARZA, YVETTE
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:
Last Name:GALARZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2422 FULLER ST
Mailing Address - Street 2:APT. #1F
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2949
Mailing Address - Country:US
Mailing Address - Phone:917-324-1456
Mailing Address - Fax:
Practice Address - Street 1:2422 FULLER ST
Practice Address - Street 2:APT. #1F
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2949
Practice Address - Country:US
Practice Address - Phone:917-324-1456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency