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General NPI Number Information
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NPI Number | 1790860419
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Entity Type | Individual
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Provider Name | JOSEE DIANE CLOUTIER M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 1 WAHOO AVE
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City | GROTON
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State | CT
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Zip | 06349-2324
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Country | US
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Telephone | 860-694-1523
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Fax |
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Provider Business Mailing Address
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Address Line | 3 HIGHWOOD RD
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City | NIANTIC
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State | CT
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Zip | 06357-1808
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Country | US
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Telephone | 860-389-2546
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Fax | 860-365-6961
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 040820
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License Number State | CT
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