Provider Demographics
NPI:1588896211
Name:GALAEI
Entity type:Organization
Organization Name:GALAEI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL CASE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:M
Authorized Official - Last Name:MORALES MITTI
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:215-851-1853
Mailing Address - Street 1:1207 CHESTNUT ST
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4101
Mailing Address - Country:US
Mailing Address - Phone:215-581-1822
Mailing Address - Fax:215-851-1775
Practice Address - Street 1:1207 CHESTNUT ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4101
Practice Address - Country:US
Practice Address - Phone:215-581-1822
Practice Address - Fax:215-851-1775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101708256Medicaid