Healthcare Provider Details

I. General information

NPI: 1487266870
Provider Name (Legal Business Name): JAMES GALINAC NURSE PRACTITIONER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 08/18/2020
Certification Date: 08/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 LABELLE ROAD
LA BELLE PA
15450
US

IV. Provider business mailing address

90 GALINAC LN
HOMER CITY PA
15748-7830
US

V. Phone/Fax

Practice location:
  • Phone: 724-364-2200
  • Fax:
Mailing address:
  • Phone: 724-388-9480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSPO21816
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: