Provider Demographics
NPI:1215904206
Name:GALANG, REYNALDO AFABLE (IDC)
Entity type:Individual
Prefix:MR
First Name:REYNALDO
Middle Name:AFABLE
Last Name:GALANG
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1056 HAWTHORNE FARM TER
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-6586
Mailing Address - Country:US
Mailing Address - Phone:757-689-2818
Mailing Address - Fax:
Practice Address - Street 1:1885 TERRIER AVE
Practice Address - Street 2:BRANCH HEALTH CLINIC DAM NECK STE 100
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23461-2298
Practice Address - Country:US
Practice Address - Phone:757-314-7215
Practice Address - Fax:757-314-7206
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman