Healthcare Provider Details

I. General information

NPI: 1659885713
Provider Name (Legal Business Name): RENEE NICOLE GALTERIO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2017
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 COLLIERS WAY
WEIRTON WV
26062-5014
US

IV. Provider business mailing address

PO BOX 779
MORGANTOWN WV
26507-0779
US

V. Phone/Fax

Practice location:
  • Phone: 304-797-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA059494
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3167
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberOA004328
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: