MEDICARE: EDGAR GALVIS LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	096468	NY
2	1041C0700X	Clinical Social Worker	44SC06157200	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053761379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDGAR GALVIS LCSW

Provider Business Mailing Address
First Line	:	936 BROADWAY FL 2
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10010-8104
Country	:	US
Telephone Number	:	551-329-7100
Fax Number	:

Provider Business Practice Location Address
First Line	:	936 BROADWAY FL 2
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10010-8104
Country	:	US
Telephone Number	:	551-329-7100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2016
Last Update Date	:	02/28/2024

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Directions to “ EDGAR GALVIS LCSW” Practice Location

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