Basic Information
Provider Information
NPI: 1184236481
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GALEGA
FirstName: ONEIL
MiddleName: DOBGIMA
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11404 PALACE CIR
Address2:  
City: GERMANTOWN
State: MD
PostalCode: 208761706
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1100 NEW JERSEY AVE SE STE 845
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200033338
CountryCode: US
TelephoneNumber: 2025456980
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/18/2020
LastUpdateDate: 08/19/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/19/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN1036747DCY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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