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Organization

ELLICOTT CITY PEDIATRIC ASSOCIATES, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
OLIVER CUSTODIO GALITA (OWNER)
(410) 465-7550
Entity
Organization

Contact information

Practice address
9011 CHEVROLET DR STE 1-6, ELLICOTT CITY, MD 21042-4024
(410) 465-7550
(410) 465-6359
Mailing address
9011 CHEVROLET DR STE 1-6, ELLICOTT CITY, MD 21042-4024
(410) 465-7550
(410) 465-6359

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
10/26/2022
Last updated
11/08/2022
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