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Individual

BRIAN S GALLANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
428 COLUMBUS AVE, NEW HAVEN, CT 06519-1233
(203) 503-3000
(203) 503-3224
Mailing address
PO BOX 7720, CREDENTIALING SPECIALIST, NEW HAVEN, CT 06519-0720
(203) 503-3174
(203) 503-3183

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
7437
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008077937
CT
01
7437
APRN
CT
01
CSP.0067398
CSR
CT
Enumeration date
02/06/2015
Last updated
03/07/2023
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