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1326136979
KENNETH KOELLE
NEW LONDON, CT
NPI
1326136979
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: CT 000199)
Enumeration Date
2006-10-10
Last Update Date
2008-02-01
Business Address
-- KENNETH KOELLE CRNA
365 MONTAUK AVE ANESTHESIA DEPT.
NEW LONDON, CT 06320-4700
Phone number: 860-442-0711
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Mailing Address
-- KENNETH KOELLE CRNA
PO BOX 32928 ANESTHESIA ASSOC OF NEW LONDON
HARTFORD, CT 06150-2928
Phone number: 800-720-1664
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