MEDICARE: DR. CHRISTOPHER R. GALBREATH DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	172390	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P010172390	OTHER	NY	EXCELLUS BLUE CHOICE
2	101214EU	OTHER	NY	PREFERRED CARE PROVIDER #
3	1777	OTHER	NY	EXCELLUS BLUE CROSS

General Provider Information

NPI Number	:	1235190521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER R. GALBREATH DO

Provider Business Mailing Address
First Line	:	1387 FAIRPORT RD
Second Line	:	SUITE 580
City	:	FAIRPORT
State	:	NY
Zip	:	14450-2003
Country	:	US
Telephone Number	:	585-377-0560
Fax Number	:	585-377-0577

Provider Business Practice Location Address
First Line	:	1387 FAIRPORT RD
Second Line	:	SUITE 580
City	:	FAIRPORT
State	:	NY
Zip	:	14450-2003
Country	:	US
Telephone Number	:	585-377-0560
Fax Number	:	585-377-0577

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	11/14/2008

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