Healthcare Provider Details

I. General information

NPI: 1154792489
Provider Name (Legal Business Name): NICHOLAS ELLIOT GALEONE DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2015
Last Update Date: 10/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 FALLON AVE
SEAFORD DE
19973-1577
US

IV. Provider business mailing address

659 S SALISBURY BLVD STE 1B
SALISBURY MD
21801-5458
US

V. Phone/Fax

Practice location:
  • Phone: 302-536-1774
  • Fax: 302-536-7096
Mailing address:
  • Phone: 410-831-3226
  • Fax: 410-677-0883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberJT-0000913
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: