Healthcare Provider Details
I. General information
NPI: 1760459903
Provider Name (Legal Business Name): MAYA GARALA PHARMD, MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/07/2006
Last Update Date: 09/02/2024
Certification Date: 09/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
404 E 16TH ST
BROOKLYN NY
11226-5601
US
IV. Provider business mailing address
125 ASHLAND PL APT 2A
BROOKLYN NY
11201-3926
US
V. Phone/Fax
- Phone: 917-749-9167
- Fax:
- Phone: 917-749-9167
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1835P1200X |
| Taxonomy | Pharmacotherapy Pharmacist |
| License Number | 10009 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0002X |
| Taxonomy | Hospice and Palliative Medicine (Internal Medicine) Physician |
| License Number | 284949-1 |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 284949-1 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: