MEDICARE: MS. ROSALEEN CHRISTINE GALVIN NURSE PRACTITIONER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	9954	CT
2	363LP2300X	Primary Care Nurse Practitioner	309638	NY

General Provider Information

NPI Number	:	1457961062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROSALEEN CHRISTINE GALVIN NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	1290 SILAS DEANE HWY
Second Line	:	HARTFORD HEALTHCARE-CVO
City	:	WETHERSFIELD
State	:	CT
Zip	:	06109-4337
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4185 BLACK ROCK TPKE STE 202
Second Line	:
City	:	FAIRFIELD
State	:	CT
Zip	:	06824-1841
Country	:	US
Telephone Number	:	203-255-4545
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2020
Last Update Date	:	11/07/2025

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