Provider Demographics
NPI:1053433839
Name:GALATIS, CALLIOPE J (OD)
Entity type:Individual
Prefix:DR
First Name:CALLIOPE
Middle Name:J
Last Name:GALATIS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1890 BEACON STREET
Mailing Address - Street 2:BASEMENT
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445
Mailing Address - Country:US
Mailing Address - Phone:617-566-0030
Mailing Address - Fax:617-232-1014
Practice Address - Street 1:1890 BEACON ST
Practice Address - Street 2:BASEMENT
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445
Practice Address - Country:US
Practice Address - Phone:617-566-0030
Practice Address - Fax:617-232-1014
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MATP 3803152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0563682OtherAETNA
MAW15975OtherBCBS
MA32845OtherDAVIS
MA0392294Medicaid
MAAA51753OtherHARVARD PILGRIM
MA772560OtherTUFTS
MAAA51753OtherHARVARD PILGRIM