Provider Demographics
NPI:1699900878
Name:GALEY, JESSICA LYNN (MD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN
Last Name:GALEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LYNN
Other - Last Name:HOOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:22 S GREENE ST
Mailing Address - Street 2:ANESTHESIOLOGY, S8C00
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1544
Mailing Address - Country:US
Mailing Address - Phone:410-328-1239
Mailing Address - Fax:410-328-0546
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:ANESTHESIOLOGY, S8C00
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-1239
Practice Address - Fax:410-328-0546
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-18
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD76766207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD982251800Medicaid
MD982251800Medicaid