Provider Demographics
NPI:1124451745
Name:GALANTI, REGINE (PHD)
Entity type:Individual
Prefix:
First Name:REGINE
Middle Name:
Last Name:GALANTI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3431 BAYFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-4623
Mailing Address - Country:US
Mailing Address - Phone:646-837-5557
Mailing Address - Fax:
Practice Address - Street 1:141 WASHINGTON AVE
Practice Address - Street 2:#200
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-0110
Practice Address - Country:US
Practice Address - Phone:646-657-8149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019113103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical