Provider Demographics
NPI:1871659151
Name:GALENO, JOHN A (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:A
Last Name:GALENO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:222 WESTCHESTER AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2906
Mailing Address - Country:US
Mailing Address - Phone:914-288-0036
Mailing Address - Fax:914-288-0692
Practice Address - Street 1:222 WESTCHESTER AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604-2906
Practice Address - Country:US
Practice Address - Phone:914-288-0036
Practice Address - Fax:914-288-0692
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY145432207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00888293Medicaid
NYC09565Medicare UPIN
NY39D561Medicare ID - Type UnspecifiedMEDICARE