Individual
CHARLES PURCELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(631) 813-7033
Mailing address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(631) 813-7033
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA5169
CT
Other
Enumeration date
04/19/2020
Last updated
05/21/2025
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