Healthcare Provider Details

I. General information

NPI: 1679962138
Provider Name (Legal Business Name): ANDREW JAMESON GALBRAITH MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2015
Last Update Date: 01/02/2024
Certification Date: 01/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 ELM ST
POTSDAM NY
13676-2166
US

IV. Provider business mailing address

167 POLK ST # 6550 SUITE 300
WATERTOWN NY
13601-2770
US

V. Phone/Fax

Practice location:
  • Phone: 315-261-5420
  • Fax:
Mailing address:
  • Phone: 315-782-7445
  • Fax: 315-779-1184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number089828
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberP95835
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: