Healthcare Provider Details

I. General information

NPI: 1467440339
Provider Name (Legal Business Name): MITCHELL JAY GALERKIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 01/12/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 S GREEN VALLEY PKWY STE 300
HENDERSON NV
89012-3145
US

IV. Provider business mailing address

35 REFLECTION BAY DR
HENDERSON NV
89011-4290
US

V. Phone/Fax

Practice location:
  • Phone: 702-832-2001
  • Fax:
Mailing address:
  • Phone: 916-768-4289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG66328
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number22625
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: