Provider Demographics
NPI:1780984153
Name:GALVIN, SEAMUS RONAN (NP)
Entity type:Individual
Prefix:MR
First Name:SEAMUS
Middle Name:RONAN
Last Name:GALVIN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 HYATT AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-4311
Mailing Address - Country:US
Mailing Address - Phone:914-473-2640
Mailing Address - Fax:
Practice Address - Street 1:1910 ARTHUR AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-6305
Practice Address - Country:US
Practice Address - Phone:914-473-2640
Practice Address - Fax:914-473-2640
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF401258-1363LP0808X
NY461868101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health