Provider Demographics
NPI:1770552242
Name:GALIZIA, FRANK LOUIS (OD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:LOUIS
Last Name:GALIZIA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 PARK AVENUE BLVD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7242
Mailing Address - Country:US
Mailing Address - Phone:570-888-5858
Mailing Address - Fax:
Practice Address - Street 1:3525 PARK AVENUE BLVD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-7242
Practice Address - Country:US
Practice Address - Phone:843-375-7036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006353152W00000X
PAOE000185152W00000X
PAOEG185152W00000X
SC2155152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2155OtherSTATE LICENSE
PA410044990OtherRR MEDICARE PIN
NYCC8362OtherRR MEDICARE GROUP
NY02108327Medicaid
PA0018038890001Medicaid
PACC9269OtherRR MEDICARE GROUP
NYP00196062OtherRR MEDICARE PIN
PA410044990OtherRR MEDICARE PIN
T020505Medicare UPIN
PACC9269OtherRR MEDICARE GROUP