MEDICARE: DR. ARLENE E KERLIN 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	207R00000X	Internal Medicine Physician	027006	CT

General Provider Information

NPI Number	:	1679559124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARLENE E KERLIN MD

Provider Business Mailing Address
First Line	:	PO BOX 1086
Second Line	:	HARTFORD MEDICAL GROUP
City	:	WILBRAHAM
State	:	MA
Zip	:	01095-1086
Country	:	US
Telephone Number	:	508-595-0531
Fax Number	:	508-829-5367

Provider Business Practice Location Address
First Line	:	1329 BOULEVARD
Second Line	:
City	:	WEST HARTFORD
State	:	CT
Zip	:	06119-1603
Country	:	US
Telephone Number	:	860-523-0538
Fax Number	:	860-523-5822

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

Provider Enumeration Date	:	12/16/2005
Last Update Date	:	07/08/2007

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