Provider Demographics
NPI:1982898607
Name:SPASSOVA, GALIA M (PT)
Entity Type:Individual
Prefix:MS
First Name:GALIA
Middle Name:M
Last Name:SPASSOVA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2142 UTOPIA PKWY
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-4142
Mailing Address - Country:US
Mailing Address - Phone:718-819-6800
Mailing Address - Fax:
Practice Address - Street 1:223 KATONAH AVE
Practice Address - Street 2:SUITE C
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-2146
Practice Address - Country:US
Practice Address - Phone:914-232-1480
Practice Address - Fax:914-232-3341
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029217225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03248Medicare PIN
NYQ4WFH1Medicare PIN