Provider Demographics
NPI:1770853764
Name:GALATI, CAROLYN ANN (MA-CCC)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ANN
Last Name:GALATI
Suffix:
Gender:F
Credentials:MA-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 PINE ST
Mailing Address - Street 2:
Mailing Address - City:BROADALBIN
Mailing Address - State:NY
Mailing Address - Zip Code:12025-3128
Mailing Address - Country:US
Mailing Address - Phone:518-954-2500
Mailing Address - Fax:518-954-2509
Practice Address - Street 1:1870 COUNTY HIGHWAY 107
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-6215
Practice Address - Country:US
Practice Address - Phone:518-954-2750
Practice Address - Fax:518-954-2759
Is Sole Proprietor?:No
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013526235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY251300000XOtherBROADALBIN PERTH TAXONOMY #
NY01414337Medicaid
NY1538212907OtherBROADALBIN PERTH CSD NPI #