Organization
PHYSICIAN SERVICES OF NORTHEAST CONNECTICUT, LLC
Active
Parent organization
DAY KIMBALL HOSPITAL
Other names
Pomfret Street Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
DAY KIMBALL HOSPITAL
Authorized official
ROBERT E SMANIK (CEO)
(860) 928-6541
Entity
Organization
Contact information
Practice address
235 POMFRET ST, PUTNAM, CT 06260-1835
(860) 928-0493
(860) 928-9255
Mailing address
PO BOX 8469, BELFAST, ME 04915-8469
(860) 928-6541
(860) 963-6450
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891962221
—
CT
Enumeration date
03/16/2009
Last updated
03/16/2009
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