Organization
EAST HADDAM MEDICAL ASSOCIATE,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA GOURLIE (OFFICE MANAGER)
(860) 873-8983
Entity
Organization
Contact information
Practice address
16 WILLIAM F PALMER RD, MOODUS, CT 06469-1131
(860) 873-1414
(860) 873-3428
Mailing address
16 WILLIAM F PALMER RD, P O BOX 430, MOODUS, CT 06469-1131
(860) 873-1414
(860) 873-3428
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
024845
CT
363A00000X
Physician Assistant
Primary
000457
CT
Other
Enumeration date
03/23/2006
Last updated
09/11/2025
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