Healthcare Provider Details

I. General information

NPI: 1114694932
Provider Name (Legal Business Name): NATALIE FERNANDA GALVEZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NATALIE GARCIA

II. Dates (important events)

Enumeration Date: 08/28/2021
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3711 QUEENS BLVD
LONG ISLAND CITY NY
11101-1725
US

IV. Provider business mailing address

226 SMITHTOWN BLVD P.O BOX 17
NESCONSET NY
11767
US

V. Phone/Fax

Practice location:
  • Phone: 718-606-3863
  • Fax:
Mailing address:
  • Phone: 917-387-5736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number714110
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: