Randy A Gallogly, IDC

Individual provider Active NPI Independent Duty Corpsman · North Franklin, CT

NPI 1356580930 · NPPES record last updated Feb 5, 2009

Key facts

NPI
1356580930
Entity type
Individual (NPI type 1)
Primary specialty
Independent Duty Corpsman 1710I1002X
Practice address
26 Baltic Rd
North Franklin, CT 06254-1402
Phone
(860) 694-2117
NPI assigned
Feb 5, 2009
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X Yes

Addresses

Primary practice location

26 Baltic Rd
North Franklin, CT 06254-1402

Mailing address

26 Baltic Rd
North Franklin, CT 06254-1402
Phone (860) 867-7514

Other providers in North Franklin, CT

All providers in North Franklin, CT · Independent Duty Corpsman in Connecticut

Sources for this page

Verify at the official NPI Registry.