Provider Demographics
NPI:1114262110
Name:GALLENSTEIN, ANNE (NP)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:GALLENSTEIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-6917
Mailing Address - Country:US
Mailing Address - Phone:516-313-7964
Mailing Address - Fax:
Practice Address - Street 1:177 MAIN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-6917
Practice Address - Country:US
Practice Address - Phone:516-313-7964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-01
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
102L00000X
AZ132181163WP0808X
AZ8831363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health