Provider Demographics
NPI:1649928029
Name:MAGUIRE, GALINA (NP)
Entity type:Individual
Prefix:
First Name:GALINA
Middle Name:
Last Name:MAGUIRE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E RIDGEWOOD AVE APT 23
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3346
Mailing Address - Country:US
Mailing Address - Phone:201-280-5547
Mailing Address - Fax:
Practice Address - Street 1:500 E RIDGEWOOD AVE APT 23
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3346
Practice Address - Country:US
Practice Address - Phone:201-280-5547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01241500363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health