Healthcare Provider Details

I. General information

NPI: 1467542365
Provider Name (Legal Business Name): MARIE GALVAO ANP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MMC - DEPT. OF CARDIOLOGY 3400 BAINBRIDGE AVE., 7TH FLR
BRONX NY
10467
US

IV. Provider business mailing address

11A RIVER LN
WESTPORT CT
06880-1926
US

V. Phone/Fax

Practice location:
  • Phone: 718-920-2248
  • Fax: 718-652-1833
Mailing address:
  • Phone: 718-920-2248
  • Fax: 718-231-6257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF301451
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: