Alexis Coughlan, PA-C
Physician Assistant in New Britain, CT. Individual provider (NPI-1).
NPI number1093460321
StatusActive
Last updated in NPPESFeb 15, 2022
Details
- NPI
- 1093460321
- Entity type
- Individual (NPI-1)
- Name
- Alexis Coughlan
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 15, 2022
- Certification date
- Feb 15, 2022
- Last updated
- Feb 15, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 5491 | CT | Yes |
Practice location
1 Lake StNew Britain, CT 06052-1396
Phone 860-832-4666
Mailing address
138 Stockade RdSouth Glastonbury, CT 06073-2115
Phone 860-713-3102
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