Provider Demographics
NPI:1093943201
Name:KINLER, RAE LYNNE POIRRIER (MD)
Entity Type:Individual
Prefix:
First Name:RAE LYNNE
Middle Name:POIRRIER
Last Name:KINLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2590 WHITNEY AVE
Mailing Address - Street 2:UNIT 2
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3044
Mailing Address - Country:US
Mailing Address - Phone:225-806-1184
Mailing Address - Fax:
Practice Address - Street 1:2590 WHITNEY AVE
Practice Address - Street 2:UNIT 2
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3044
Practice Address - Country:US
Practice Address - Phone:225-806-1184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT52535208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery