Individual
MRS. KERLINE VASSELL KLAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1062 BARNES ROAD, SUITE 102, WALLINGFORD, CT 06492
(203) 294-6328
(203) 294-6346
Mailing address
1062 BARNES ROAD, SUITE 102, WALLINGFORD, CT 06492
(203) 294-6328
(203) 294-6346
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
035161
CT
2080A0000X
Pediatric Adolescent Medicine Physician
035161
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001351618
—
CT
01
—
035161
CONNECTICARE
—
01
—
996984
AETNA
—
01
—
OQ2727
HEALTH NET
—
01
—
PH88980
OXFORD
—
Enumeration date
10/30/2006
Last updated
07/08/2011
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