Provider Demographics
NPI:1780680884
Name:GALAN, LAURENTIU P (MD)
Entity Type:Individual
Prefix:
First Name:LAURENTIU
Middle Name:P
Last Name:GALAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 SACHEM ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-4128
Mailing Address - Country:US
Mailing Address - Phone:860-885-0666
Mailing Address - Fax:860-885-1158
Practice Address - Street 1:119 SACHEM ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-4128
Practice Address - Country:US
Practice Address - Phone:860-885-0666
Practice Address - Fax:860-885-1158
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2007-07-08
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-24
Provider Licenses
StateLicense IDTaxonomies
CT035967208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT227401OtherPREFERRED ONE
CT2V4756OtherHEALTHNET
CT750244OtherCONNECTICARE
CT3457232OtherAETNA
CTP3239776OtherOXFORD
CT2316305OtherCIGNA
CTG61018Medicare UPIN