Provider Demographics
NPI:1013939974
Name:GALEA, PATRICIA MARY (NP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:MARY
Last Name:GALEA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:204 S PERRY ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12095-2817
Mailing Address - Country:US
Mailing Address - Phone:518-762-8202
Mailing Address - Fax:518-773-8813
Practice Address - Street 1:50 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-3126
Practice Address - Country:US
Practice Address - Phone:518-773-3881
Practice Address - Fax:518-773-8813
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300577363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY38641PMedicare UPIN