Individual
MRS. MARIE HELENE POULIOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1062 BARNES ROAD, SUITE 102, WALLINGFORD, CT 06492
(203) 294-6328
(203) 294-6346
Mailing address
1062 BARNES ROAD, SUITE 102, WALLINGFORD, CT 06492
(203) 294-6328
(203) 294-6346
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
038992
CT
2080A0000X
Pediatric Adolescent Medicine Physician
038992
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001389924
—
CT
01
—
2822247
AETNA
—
01
—
2V5651
HEALTH NET
—
01
—
739460
CONNECTICARE
—
01
—
P2664394
OXFORD
—
Enumeration date
10/30/2006
Last updated
07/07/2011
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