Individual
MRS. KERIAN SERVICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
150 N MAIN ST, MANCHESTER, CT 06042-2003
(860) 528-1359
(860) 290-4142
Mailing address
94 CONNECTICUT BLVD, EAST HARTFORD, CT 06108-3013
(860) 528-1359
(860) 290-4142
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
049742
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007228810
—
CT
Enumeration date
06/12/2008
Last updated
12/23/2011
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