| Doctor Name: | DR. EDMUND ANTHONY GANAL |
| NPI Number: | 1003808767 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | A89360 |
| Business Practice Address: | 1 High St Wakefield, RI - 028793103 |
| Business Phone Number: | 8582599200 |
| Business Fax Number: | |
| Mailing Address: | 131 Kent Rd, NEW MILFORD |
| State: | CT |
| Postal Code: | 067763485 |
| Phone Number: | 8603558000 |
| Fax Number: | 8603506291 |
| NPI Enumeration Date: | 08/18/2005 |
| NPI Last Update Date: | 06/03/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A89360 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |