Mrs Marie Helene Pouliot, MD | |
1062 Barnes Road, Suite 102, Wallingford, CT 06492 | |
(203) 294-6328 | |
(203) 294-6346 |
Full Name | Mrs Marie Helene Pouliot |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 1062 Barnes Road, Wallingford, Connecticut |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1982780227 | NPI | - | NPPES |
001389924 | Medicaid | CT | |
P2664394 | Other | OXFORD | |
739460 | Other | CONNECTICARE | |
2822247 | Other | AETNA | |
2V5651 | Other | HEALTH NET |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 038992 (Connecticut) | Primary |
2080A0000X | Pediatrics - Adolescent Medicine | 038992 (Connecticut) | Secondary |
Entity Name | Prohealth Physicians Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720194053 PECOS PAC ID: 1355246950 Enrollment ID: O20031205000602 |
Mailing Address | Practice Location Address |
---|---|
Mrs Marie Helene Pouliot, MD 1062 Barnes Road, Suite 102, Wallingford, CT 06492 Ph: (203) 294-6328 | Mrs Marie Helene Pouliot, MD 1062 Barnes Road, Suite 102, Wallingford, CT 06492 Ph: (203) 294-6328 |
Mrs. Lisa Marie Bankowski, RN Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1062 Barnes Road, Suite 102, Wallingford, CT 06492 Phone: 203-294-6328 Fax: 203-294-6346 | |
Dr. Steve M Frank, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 97 Barnes Road, Suite 6, Wallingford, CT 06492 Phone: 203-265-9890 Fax: 203-265-3321 | |
Rochelle Turetsky, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: Gaylord Farms Rd., Wallingford, CT 06492 Phone: 203-284-2800 Fax: 203-679-3598 | |
Allison J Beitel, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 97 Barnes Road, Suite 6, Wallingford, CT 06492 Phone: 203-265-9890 Fax: 203-265-3321 | |
Mrs. Kerline Vassell Klaus, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1062 Barnes Road, Suite 102, Wallingford, CT 06492 Phone: 203-294-6328 Fax: 203-294-6346 | |
Dr. Miriam Susan Cohen, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 97 Barnes Rd, Ste 6, Wallingford, CT 06492 Phone: 203-753-6776 Fax: 203-573-1875 | |
Dr. Vivian P Tsuei, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1062 Barnes Rd, Suite 102, Wallingford, CT 06492 Phone: 203-294-6328 |