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Individual

CINDY IRENE BOUTILIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
20 YORK STREET CB 2041, NORTHEAST MEDICAL GROUP, NEW HAVEN, CT 06510
(203) 688-4748
(203) 688-4740
Mailing address
20 YORK STREET CB 2041, NORTHEAST MEDICAL GROUP, NEW HAVEN, CT 06510
(203) 688-4748
(203) 688-4740

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
77555
CT
363L00000X
Nurse Practitioner
Primary
004582
CT

Other

Enumeration date
12/07/2010
Last updated
08/17/2015
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