Organization
CONNECTICUT CHILDREN'S MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE MARIE CLOUTIER MD (DIRECTOR)
(860) 545-9442
Entity
Organization
Contact information
Practice address
282 WASHINGTON ST, ASTHMA CENTER - HARTFORD SQUARE WEST, HARTFORD, CT 06106-3322
(860) 545-9000
(860) 545-8979
Mailing address
282 WASHINGTON ST, HARTFORD, CT 06106-3322
(860) 545-9000
(860) 545-8979
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
026130
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026130
PHYSICIAN/SURGEON LICENSE
CT
Enumeration date
10/12/2006
Last updated
09/11/2007
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