Individual
DR. CHARLES E POLETTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 FOUNDERS PLZ, #300 C/O IPMS, EAST HARTFORD, CT 06108-3212
(860) 282-4137
(860) 282-0170
Mailing address
111 FOUNDERS PLZ, #300 C/O IPMS, EAST HARTFORD, CT 06108-3212
(860) 282-4137
(860) 282-0170
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
031514
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001315143
—
CT
Enumeration date
11/03/2005
Last updated
05/18/2012
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