Basic Information
Provider Information
NPI: 1700015658
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GALAZKA
FirstName: PATRYCJA
MiddleName: Z
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
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Mailing Information
Address1: 2801 W KINNICKINNIC RIVER PKWY
Address2:  
City: MILWAUKEE
State: WI
PostalCode: 532153669
CountryCode: US
TelephoneNumber: 4146493530
FaxNumber:  
Practice Location
Address1: 2801 W KINNICKINNIC RIVER PKWY
Address2:  
City: MILWAUKEE
State: WI
PostalCode: 532153669
CountryCode: US
TelephoneNumber: 4146493530
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/13/2009
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X67990WIY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207R00000X125-057083ILN Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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