Provider Demographics
NPI:1912991175
Name:EPSTEIN, SERLE MINDELL (MD)
Entity Type:Individual
Prefix:DR
First Name:SERLE
Middle Name:MINDELL
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 WOODLAND RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-2685
Mailing Address - Country:US
Mailing Address - Phone:203-245-7959
Mailing Address - Fax:203-245-5864
Practice Address - Street 1:6 WOODLAND RD
Practice Address - Street 2:SUITE 4
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-2685
Practice Address - Country:US
Practice Address - Phone:203-245-7959
Practice Address - Fax:203-245-5864
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT024871207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT10008663OtherMEDICARE RAILROAD
CT24871OtherSAGA
CT0Q0062OtherHEALTH NET
CT01024871OtherCIGNA
CT024871OtherCONNECTICARE
CT010024871CT01OtherANTHEM
CT1051406OtherAETNA
CT24871OtherAARP
CT24871OtherSAGA