Individual
SUZANNE M POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12A LEDGEBROOK DR, MANSFIELD CENTER, CT 06250-1690
(860) 423-2960
(860) 423-3719
Mailing address
320 POMFRET ST, PUTNAM, CT 06260-1836
(860) 963-6390
(860) 963-6343
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
042791
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001427914
—
CT
Enumeration date
10/11/2005
Last updated
05/04/2023
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