Provider Demographics
NPI:1720712201
Name:GALVAN LIRANZO, Y
Entity Type:Individual
Prefix:
First Name:Y
Middle Name:
Last Name:GALVAN LIRANZO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:BOGOTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07603-1706
Mailing Address - Country:US
Mailing Address - Phone:646-359-8034
Mailing Address - Fax:
Practice Address - Street 1:180 CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:BOGOTA
Practice Address - State:NJ
Practice Address - Zip Code:07603-1706
Practice Address - Country:US
Practice Address - Phone:646-359-8034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist