Healthcare Provider Details

I. General information

NPI: 1366531782
Provider Name (Legal Business Name): CATHERINE A GALVIN RNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MMC - DEPT. OF CARDIOLOGY 3400 BAINBRIDGE AVENUE
BRONX NY
10467
US

IV. Provider business mailing address

1713 BELLEWOOD AVE
WALL TOWNSHIP NJ
07719-3427
US

V. Phone/Fax

Practice location:
  • Phone: 718-920-2248
  • Fax:
Mailing address:
  • Phone: 718-920-2248
  • Fax: 718-655-4292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF301826
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: