Organization
SERGE P. POULIN, MD
Active
Parent organization
SERGE P. POULIN, MD
Organization subpart
Yes
Provider details
NPI number
Legal business name
SERGE P. POULIN, MD
Authorized official
LOUISE POULIN (MANAGER)
(860) 649-6900
Entity
Organization
Contact information
Practice address
315 E CENTER ST, MANCHESTER, CT 06040-5251
(860) 649-6900
(860) 647-0469
Mailing address
315 E CENTER ST, MANCHESTER, CT 06040-5251
(860) 649-6900
(860) 647-0469
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010027117CT01
BC
CT
01
—
0102711703
CIGNA
CT
01
—
0104460
UNITED
CT
01
—
027117
CONNECTICARE
CT
01
—
0V0122
HEALTHNET
CT
Enumeration date
10/18/2007
Last updated
10/18/2007
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