Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

East Haddam Medical Associate, PC

Organization Family Medicine Physician · NPI 1063472363

East Haddam Medical Associate, PC provides Family Medicine Physician services in Moodus, Connecticut. Licensed in Connecticut. Registered with an NPI since 2006.

Licensed in
CT
In the registry since
2006
Specialties on file
2
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

16 William F Palmer Rd
Moodus, CT 06469-1131
Phone: (860) 873-1414
Fax: (860) 873-3428
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 000457 (CT)
Family Medicine Physician Taxonomy 207Q00000X · Licence 024845 (CT)

Record details

NPI number1063472363
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Pamela Gourlie — Office Manager · (860) 873-8983
NPI enumeratedMarch 23, 2006
Last updated in NPPESSeptember 11, 2025
Mailing address16 William F Palmer Rd, P O Box 430, Moodus, CT 06469-1131

Other providers in Moodus