Individual
JUSTIN GAUTHIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(860) 442-0711
Mailing address
450 CLARKSON AVE, BROOKLYN, NY 11203-2012
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
66421
CT
Other
Enumeration date
06/23/2014
Last updated
09/23/2020
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