Individual
JENNIFER POTHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 DAKOTA DR STE 218, NEW HYDE PARK, NY 11042-1136
(516) 488-9700
(516) 488-8826
Mailing address
47 TOWN ST, NORWICH, CT 06360-2315
(860) 892-7042
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
315296
NY
207Q00000X
Family Medicine Physician
52266
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008046940
—
CT
05
—
07530096
—
NY
Enumeration date
07/17/2013
Last updated
07/17/2024
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