Autumn Lynn Poulin

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PA4831 Issued in ME

Practice address

37 Pond St
Bangor, ME 04401-4641

Phone

(207) 945-4334

NPI assigned

Sep 29, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1154830420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 NYES CORNER DR",
            "city": "FAIRFIELD",
            "state": "ME",
            "postal_code": "049373414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 POND ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014641",
            "telephone_number": "207-945-4334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Medical Center Pkwy",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "ME",
            "postal_code": "043308160",
            "country_code": "US",
            "telephone_number": "207-626-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POULIN",
        "first_name": "AUTUMN",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "ME",
            "license": "PA4831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Porter, LCSW
• Tabitha Portera, LCPC
• Anthony W Posuniak, FNP-BC
• Erik Ross Potter, LMSW-CC
• Amanda Moon Poulin, RD,LD,CDE
• Thomas G Poulin
• Markos Poulopoulos, M.D.
• Pouzol Physical Therapy, PA
• Philip R Pouzol, PT
• Stephanie Pouzol, DMD

• Physical Medicine & Rehabilitation Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Physical Medicine & Rehabilitation Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.