Provider Demographics
NPI:1609353309
Name:GALENTE, HAYLEY (PA-C)
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:
Last Name:GALENTE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 ELM ST
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-2915
Mailing Address - Country:US
Mailing Address - Phone:860-210-5000
Mailing Address - Fax:
Practice Address - Street 1:21 ELM ST
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-2915
Practice Address - Country:US
Practice Address - Phone:860-210-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-25
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4170363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4170OtherSTATE LICENSE