Provider Demographics
NPI:1952399552
Name:NORMANDIN, MICHELE P (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:P
Last Name:NORMANDIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:245 ALVORD PARK RD
Mailing Address - Street 2:BLDG B
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-3493
Mailing Address - Country:US
Mailing Address - Phone:860-496-0455
Mailing Address - Fax:860-496-2793
Practice Address - Street 1:245 ALVORD PARK RD
Practice Address - Street 2:BLDG B
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-3493
Practice Address - Country:US
Practice Address - Phone:860-496-0455
Practice Address - Fax:860-496-2793
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2013-11-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT036886207ZC0500X, 207ZP0102X
CT36886207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001368861Medicaid
220000607Medicare UPIN
G70654Medicare UPIN