Physician Assistant
EAST HADDAM MEDICAL ASSOCIATE,PC
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1063472363 · enumerated 2006-03-23 · record updated 2025-09-11. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: Ms. PAMELA GOURLIE, OFFICE MANAGER · (860) 873-8983
Addresses and phones
- Mailing address 16 WILLIAM F PALMER RD, P O BOX 430, MOODUS, CT, 06469-1131 (860) 873-1414 Fax (860) 873-3428 Google Maps Apple Maps OpenStreetMap
- Practice location 16 WILLIAM F PALMER RD, MOODUS, CT, 06469-1131 (860) 873-1414 Fax (860) 873-3428 Google Maps Apple Maps OpenStreetMap
Specialties
- Family Medicine 207Q00000X · License 024845 CT
- Physician Assistant 363A00000X · Primary · License 000457 CT
In this directory
Locations and evidence
-
Practice location
MOODUS, CT, 064691131
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.