# PHYSICIAN SERVICES OF NORTHEAST

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DAY KIMBALL HEALTHCARE INC DBA DA
- **Other names:** Physician Services of Northeast Connecticut, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1891962221
- **Legal business name:** DAY KIMBALL HEALTHCARE INC DBA DA
- **Authorized official:** JULIE DROUIN (CFO)
- **Authorized official phone:** (860) 928-6541

## Contact information

- **Practice address:** 320 POMFRET ST, SUITE CSB2, PUTNAM, CT 06260-1836
- **Practice address phone:** (860) 928-6541
- **Practice address fax:** (860) 963-6450
- **Mailing address:** 320 POMFRET ST, SUITE CSB2, PUTNAM, CT 06260-1836
- **Mailing address phone:** (860) 928-6541
- **Mailing address fax:** (860) 963-6450

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 176B00000X | Midwife | — | CT | — |
| 207N00000X | Dermatology Physician | — | NULL | — |
| 207N00000X | Dermatology Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 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