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General NPI Number Information
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NPI Number | 1225305535
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Entity Type | Individual
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Provider Name | AGATA ELWIRA GALESKA CFY-SLP
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Gender | Female
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Dates
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Enumeration Date | 11/30/2011
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Last Update Date | 11/30/2011
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Provider Practice Location Address
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Address Line | 3 INDUSTRIAL WAY E
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City | EATONTOWN
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State | NJ
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Zip | 07724-3318
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Country | US
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Telephone | 732-544-1557
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Fax |
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Provider Business Mailing Address
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Address Line | 454 BARCLAY ST
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City | PERTH AMBOY
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State | NJ
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Zip | 08861-3128
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Country | US
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Telephone | 732-442-6680
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | TL1948
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License Number State | NJ
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