Provider Demographics
NPI:1790818219
Name:GALPERIN, VADIM FELIKSOVICH
Entity Type:Individual
Prefix:
First Name:VADIM
Middle Name:FELIKSOVICH
Last Name:GALPERIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7363 190TH ST
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1853
Mailing Address - Country:US
Mailing Address - Phone:718-776-0796
Mailing Address - Fax:718-776-0796
Practice Address - Street 1:7363 190TH ST
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1853
Practice Address - Country:US
Practice Address - Phone:718-776-0796
Practice Address - Fax:718-776-0796
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010147-1174400000X, 225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No174400000XOther Service ProvidersSpecialist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics