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Richard Soucier

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NPI Number Detailed Information

Provider Information:

Name: Richard Soucier
Gender: M
Provider License Number If Given: 33435

NPI Information:

NPI: 1255334207
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 9/27/2016

Provider Business Mailing Address:

Address: 1000 ASYLUM AVE STE 4309
Hartford, CT 06105
Phone Number: 8607146581
Fax Number: 8607148311

Provider Business Practice Location Address:

Address: 114 WOODLAND ST
Hartford, CT 06105
Phone Number: 8607144820
Fax Number: 8607148001

Provider Taxonomy:

Primary: 207RC0000X
Secondary (if any): 207RA0001X
State: CT

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