Provider Demographics
NPI:1982245247
Name:GALINZOGA, OLIVIA JOY
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:JOY
Last Name:GALINZOGA
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 1:155 CLAREMONT AVE # 424
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-4003
Mailing Address - Country:US
Mailing Address - Phone:956-229-9271
Mailing Address - Fax:
Practice Address - Street 1:155 CLAREMONT AVE # 424
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-4003
Practice Address - Country:US
Practice Address - Phone:956-229-9271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant