Provider Demographics
NPI:1881741718
Name:GALINA, DAVID (OD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:GALINA
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 1:1633 ROUTE 202 # STORE108
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-2925
Mailing Address - Country:US
Mailing Address - Phone:845-354-5661
Mailing Address - Fax:845-262-1545
Practice Address - Street 1:1633 ROUTE 202 # STORE108
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-2925
Practice Address - Country:US
Practice Address - Phone:845-354-5661
Practice Address - Fax:845-262-1545
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYUV004778152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU29157Medicare UPIN
NYC45011Medicare PIN
NYC45012Medicare PIN
NY0323390002Medicare NSC