MEDICARE: TARA GALAN

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	103K00000X	Behavior Analyst	1-24-75157	NY

General Provider Information

NPI Number	:	1376377168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA GALAN

Provider Business Mailing Address
First Line	:	163 RAMONA AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-2716
Country	:	US
Telephone Number	:	347-302-5498
Fax Number	:

Provider Business Practice Location Address
First Line	:	163 RAMONA AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-2716
Country	:	US
Telephone Number	:	347-302-5498
Fax Number	:

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

Provider Enumeration Date	:	08/26/2024
Last Update Date	:	01/16/2026

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Directions to “ TARA GALAN ” Practice Location

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