Provider Demographics
NPI:1891476727
Name:GALELA, BENJAMIN (BA)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:GALELA
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 WHITE TAIL RUN
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44410-2611
Mailing Address - Country:US
Mailing Address - Phone:330-984-6082
Mailing Address - Fax:
Practice Address - Street 1:255 WHITE TAIL RUN
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:OH
Practice Address - Zip Code:44410-2611
Practice Address - Country:US
Practice Address - Phone:330-984-6082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health