MEDICARE: LYNNAE GALELLA PA

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	363AM0700X	Medical Physician Assistant	MA057253L	PA

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	:	1629471107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNNAE GALELLA PA

Provider Business Mailing Address
First Line	:	1099 S TOWNSHIP BLVD
Second Line	:
City	:	PITTSTON
State	:	PA
Zip	:	18640-3247
Country	:	US
Telephone Number	:	570-655-6759
Fax Number	:	570-883-7446

Provider Business Practice Location Address
First Line	:	1099 S TOWNSHIP BLVD
Second Line	:
City	:	PITTSTON
State	:	PA
Zip	:	18640-3247
Country	:	US
Telephone Number	:	570-655-6759
Fax Number	:	570-883-7446

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

Provider Enumeration Date	:	09/29/2014
Last Update Date	:	08/12/2021

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Directions to “ LYNNAE GALELLA PA” Practice Location

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