Individual
JENNIFER LYN SUTHERLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D., M.P.H
Contact information
Practice address
250 FLAT ROCK PLACE, PHYS OFF 1, WESTBROOK, CT 06498-3585
(860) 358-3640
(860) 358-8656
Mailing address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 358-6000
(860) 358-8661
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
051698
CT
207Q00000X
Family Medicine Physician
232049
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008050305
—
CT
Enumeration date
05/21/2007
Last updated
05/07/2024
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