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1750469037

NPI Code Detail

MEDICARE: PAQUI D MOTYL MD

MEDICARE: PAQUI D MOTYL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	033964	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	060646704	OTHER		TRI-CARE
4	P00120176	OTHER		CLINIC

General Provider Information

NPI Number	:	1750469037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAQUI D MOTYL MD

Provider Business Mailing Address
First Line	:	112 LAFAYETTE ST
Second Line	:
City	:	NORWICH
State	:	CT
Zip	:	06360-2737
Country	:	US
Telephone Number	:	860-848-1297
Fax Number	:	860-848-9875

Provider Business Practice Location Address
First Line	:	80 NORWICH NEW LONDON TPKE
Second Line	:
City	:	UNCASVILLE
State	:	CT
Zip	:	06382-2527
Country	:	US
Telephone Number	:	860-848-1297
Fax Number	:	860-848-9875

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	03/05/2014

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Directions to “ PAQUI D MOTYL MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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