Provider Demographics
NPI:1295919637
Name:GALAYDA, WENDY A (LICENSE PRACTICAL NU)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:A
Last Name:GALAYDA
Suffix:
Gender:F
Credentials:LICENSE PRACTICAL NU
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 WARBURTON AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706-2809
Mailing Address - Country:US
Mailing Address - Phone:914-478-0353
Mailing Address - Fax:
Practice Address - Street 1:228 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:WEST HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10604-2016
Practice Address - Country:US
Practice Address - Phone:914-686-2448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY71151164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01502203Medicaid