Serge P. Poulin, Md

LBN: Serge P. Poulin, Md
Serge P. Poulin, Md is an health care organization with primary practice located at 629 E Middle Tpke , Manchester CT 06040-3731. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Serge P. Poulin, Md can be contacted via phone (860) 649-6900, or through Poulin, Lousie via phone (860) 649-6900.

Contact Information

Primary practice address
629 E Middle Tpke Manchester CT 06040-3731
Phone: (860) 649-6900
Fax: (860) 647-0469
Website:
Map and Directions
Authorized official contact:
Name: Poulin, Lousie
Phone: (860) 649-6900

Health care specialties

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

Profile Details

NPI number 1770860504
LBN Legal business name Serge P. Poulin, Md
DBA Doing business as
Authorized official Poulin, Lousie
Entity Organization
Organization subpart 1 No
Enumeration date Nov 8th, 2011
Last updated Nov 8th, 2011 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1770860504 NPPES
Connecticut MEDICAID 0027117

Popular Providers