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General NPI Number Information
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NPI Number | 1659204592
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Entity Type | Individual
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Provider Name | HEIDI POARCH PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/08/2026
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Last Update Date | 06/08/2026
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Provider Practice Location Address
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Address Line | 863 N MAIN STREET EXT STE 301
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City | WALLINGFORD
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State | CT
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Zip | 06492-2434
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Country | US
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Telephone | 203-269-0885
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Fax | 203-269-3496
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Provider Business Mailing Address
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Address Line | 1404 SPINDLE HILL RD
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City | WOLCOTT
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State | CT
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Zip | 06716-1228
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Country | US
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Telephone | 203-364-7621
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 7771
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License Number State | CT
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