Healthcare Provider Details

I. General information

NPI: 1780954750
Provider Name (Legal Business Name): LAURENTIU P GALAN, MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2012
Last Update Date: 01/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 LAFAYETTE ST
NORWICH CT
06360-3408
US

IV. Provider business mailing address

36 LAFAYETTE ST
NORWICH CT
06360-3408
US

V. Phone/Fax

Practice location:
  • Phone: 860-885-0666
  • Fax: 860-885-1158
Mailing address:
  • Phone: 860-885-0666
  • Fax: 860-885-1158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0035967
License Number StateCT

VIII. Authorized Official

Name: MARCI REDINGER
Title or Position: OFFICE MANAGER
Credential:
Phone: 860-885-0666