Provider Demographics
NPI:1174573539
Name:GALASSO, FRANCO (MD)
Entity type:Individual
Prefix:
First Name:FRANCO
Middle Name:
Last Name:GALASSO
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 1:133 SCOVILL ST STE 101
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06706-1127
Mailing Address - Country:US
Mailing Address - Phone:203-709-5680
Mailing Address - Fax:203-709-5688
Practice Address - Street 1:133 SCOVILL ST STE 101
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06706-1127
Practice Address - Country:US
Practice Address - Phone:203-709-5680
Practice Address - Fax:203-709-5688
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT028668207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001286683Medicaid
CTB39285Medicare UPIN
CT110008789Medicare ID - Type Unspecified