Healthcare Provider Details

I. General information

NPI: 1427112846
Provider Name (Legal Business Name): MICHELLE SERLIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 LOCK ST
NEW HAVEN CT
06511-3603
US

IV. Provider business mailing address

289 PURITAN RD
FAIRFIELD CT
06824-6837
US

V. Phone/Fax

Practice location:
  • Phone: 203-432-0206
  • Fax:
Mailing address:
  • Phone: 203-645-6341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number046667
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: