Provider Demographics
NPI:1902910219
Name:GALANTE, NICOLE K (DC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:K
Last Name:GALANTE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 MASON BAY RD
Mailing Address - Street 2:
Mailing Address - City:JONESPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04649-3501
Mailing Address - Country:US
Mailing Address - Phone:207-497-2996
Mailing Address - Fax:
Practice Address - Street 1:66 MAIN ST.
Practice Address - Street 2:
Practice Address - City:MILBRIDGE
Practice Address - State:ME
Practice Address - Zip Code:04658
Practice Address - Country:US
Practice Address - Phone:207-546-3057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1170111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME210390099Medicaid
ME350052171OtherRAILROAD MEDICARE
MEMN4133OtherHARVARD PILGRIM
ME098672OtherBCBS
ME2485306OtherAETNA
ME2467127OtherAETNA
MEM183695OtherCIGNA
MEMM8615Medicare PIN
ME2467127OtherAETNA