Active NPI
Kenneth D. Galen, M.D.
- Forensic Psychiatry Physician
- Riverside, CA
National Provider Identifier
1336474055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychiatry Physician
- License
- 037287
- Practice address
- 2085 Rustin Ave Ste 1
Riverside, CA 92507-2498 - Phone
- (951) 955-7320
- NPI assigned
- Oct 14, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychiatry Physician | 2084F0202X | 037287 | CT | Primary |
Addresses
Primary practice location
2085 Rustin Ave Ste 1
Riverside, CA 92507-2498
Mailing address
1000 Silver St.
Middletown, CT 06489
Phone (860) 262-6512
Other practice location 1
1000 Silver St.
Middletown, CT 06489
Phone (860) 262-6512
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 037287 | CT | MD | Forensic Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663891200000",
"number": "1336474055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 SILVER ST.",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "06489",
"telephone_number": "860-262-6512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2085 RUSTIN AVE STE 1",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925072498",
"telephone_number": "951-955-7320"
}
],
"practiceLocations": [
{
"address_1": "1000 Silver St.",
"address_purpose": "LOCATION",
"city": "Middletown",
"state": "CT",
"postal_code": "06489",
"country_code": "US",
"telephone_number": "860-262-6512",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GALEN",
"first_name": "KENNETH",
"middle_name": "D.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-10-14",
"last_updated": "2022-09-23",
"certification_date": "2022-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "2084F0202X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Forensic Psychiatry",
"state": "CT",
"license": "037287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.