Healthcare Provider Details

I. General information

NPI: 1518450030
Provider Name (Legal Business Name): EDUARD GALPER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2018
Last Update Date: 02/27/2021
Certification Date: 02/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 POMEROY AVE
MERIDEN CT
06450-7165
US

IV. Provider business mailing address

211 POMEROY AVE
MERIDEN CT
06450-7165
US

V. Phone/Fax

Practice location:
  • Phone: 201-378-8582
  • Fax:
Mailing address:
  • Phone: 201-378-8582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code2471C1101X
TaxonomyCardiovascular-Interventional Technology Radiologic Technologist
License Number
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: