Healthcare Provider Details

I. General information

NPI: 1952476079
Provider Name (Legal Business Name): GALINA KSHIK CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 DELL CT
SOUTHAMPTON PA
18966-6003
US

IV. Provider business mailing address

680 BLAIR MILL RD
HORSHAM PA
19044-2223
US

V. Phone/Fax

Practice location:
  • Phone: 267-288-8309
  • Fax:
Mailing address:
  • Phone: 412-554-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP008978
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: