Poulin, Serge Peter

Poulin, Serge Peter is an sole proprietor health care provider with primary practice located at 315 E. Center St , Manchester CT 06040. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Poulin, Serge Peter can be contacted via phone (860) 649-6900.

Contact Information

Primary practice address
315 E. Center St Manchester CT 06040
Fax: (860) 647-0469
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 027117 Connecticut

Profile Details

NPI number 1215954938
LBN Legal business name Poulin, Serge Peter
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 17th, 2006
Last updated May 11th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215954938 NPPES
Connecticut MEDICAID 027117
Connecticut MEDICAID 001271171

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