Provider Demographics
NPI:1295828549
Name:COUTURE, PAULE C (MD)
Entity Type:Individual
Prefix:DR
First Name:PAULE
Middle Name:C
Last Name:COUTURE
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 1:126 MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5431
Mailing Address - Country:US
Mailing Address - Phone:203-327-1055
Mailing Address - Fax:203-323-6177
Practice Address - Street 1:126 MORGAN ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5431
Practice Address - Country:US
Practice Address - Phone:203-327-1055
Practice Address - Fax:203-323-6177
Is Sole Proprietor?:No
Enumeration Date:2006-10-01
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT027796208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1277963Medicaid
CT061080678OtherTIN
CT1277963Medicaid