Organization
PHYSICIAN SERVICES OF NORTHEAST
Active
Organization
PHYSICIAN SERVICES OF NORTHEAST
Active
Other names
PHYSICIAN SERVICES OF NORTHEAST CT, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE L VALLEE (VP PHYSICIAN SERVICES)
(860) 928-6541
Entity
Organization
Contact information
Practice address
320 POMFRET ST, PUTNAM, CT 06260-1836
(860) 928-6541
(860) 963-6450
Mailing address
PO BOX 8469, BELFAST, ME 04915-8469
(860) 928-6541
(860) 963-6450
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
—
—
261Q00000X
Clinic/Center
Primary
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008001905
—
CT
Enumeration date
10/25/2011
Last updated
10/25/2011
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