Individual
KEREN MARIAM JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA- CERTIFIED
Contact information
Practice address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(860) 442-0711
Mailing address
COMMUNITY HEALTH CENTER, 675 MAIN STREET, MIDDLETOWN, CT 06457
(516) 510-4160
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-14522
NC
363A00000X
Physician Assistant
4523
CT
Other
Enumeration date
02/13/2019
Last updated
08/15/2025
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