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Organization
PHYSICIAN SERVICES OF NORTHEAST
Active
Organization
PHYSICIAN SERVICES OF NORTHEAST
Active
Parent organization
DAY KIMBALL HEALTHCARE INC DBA DA
Other names
Physician Services of Northeast Connecticut, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DAY KIMBALL HEALTHCARE INC DBA DA
Authorized official
JULIE DROUIN (CFO)
(860) 928-6541
Entity
Organization
Contact information
Practice address
320 POMFRET ST, SUITE CSB2, PUTNAM, CT 06260-1836
(860) 928-6541
(860) 963-6450
Mailing address
320 POMFRET ST, SUITE CSB2, PUTNAM, CT 06260-1836
(860) 928-6541
(860) 963-6450
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
—
CT
207N00000X
Dermatology Physician
—
NULL
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207QA0000X
Adolescent Medicine (Family Medicine) Physician
—
NULL
207QA0000X
Adolescent Medicine (Family Medicine) Physician
—
—
207QA0505X
Adult Medicine Physician
—
NULL
207QA0505X
Adult Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
Other
Enumeration date
05/14/2008
Last updated
09/16/2011
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