Provider Type Icon

SERGE P. POULIN MD NPI 1770860504


NPI Information

NPI: 1770860504
Provider Name: SERGE P. POULIN, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
629 E MIDDLE TPKE
MANCHESTER, CT
ZIP 06040
Phone: (860) 649-6900
Get Directions

SERGE P. POULIN, MD is a family medicine in Manchester, CT. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SERGE P. POULIN, MD NPI is 1770860504. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

629 E MIDDLE TPKE
MANCHESTER, CT
ZIP 06040-731
Phone: (860) 649-6900
Fax: (860) 647-0469

The provider's authorized official is Lousie Poulin .
The authorized official title is Office Manager and has the following contact phone number (860) 649-6900.

The enumeration date for this NPI number is 11/8/2011 and was last updated on 11/8/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine027117CONNECTICUTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10027117MEDICAIDCONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.