Individual
ALEXIS COUGHLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 LAKE ST, NEW BRITAIN, CT 06052-1396
(860) 832-4666
Mailing address
138 STOCKADE RD, SOUTH GLASTONBURY, CT 06073-2115
(860) 713-3102
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5491
CT
Other
Enumeration date
02/15/2022
Last updated
02/15/2022
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