Provider Demographics
NPI:1114585445
Name:GALANG, FAUSTINO TORRES JR (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:FAUSTINO
Middle Name:TORRES
Last Name:GALANG
Suffix:JR
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:84 BROOKSHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-3804
Mailing Address - Country:US
Mailing Address - Phone:860-910-9199
Mailing Address - Fax:
Practice Address - Street 1:84 BROOKSHAVEN RD
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-3804
Practice Address - Country:US
Practice Address - Phone:860-910-9199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-01
Last Update Date:2019-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT011831225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist