Provider Demographics
NPI:1386807956
Name:SAMOYLOVICH, GALINA (FNP, MS RN)
Entity type:Individual
Prefix:MS
First Name:GALINA
Middle Name:
Last Name:SAMOYLOVICH
Suffix:
Gender:F
Credentials:FNP, MS RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2637 E 19TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3302
Mailing Address - Country:US
Mailing Address - Phone:917-324-1849
Mailing Address - Fax:
Practice Address - Street 1:2546 E 11TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5012
Practice Address - Country:US
Practice Address - Phone:917-324-1849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF334422363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily