Michael John Portal

NPI #1265206056 in Manchester, Connecticut

Provider Information

NPI Number: 1265206056
Entity Type: Individual
Name: Michael John Portal
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Nov 13, 2023
Last Updated: Jul 22, 2024

Practice Location

Address: 71 HAYNES ST
City: Manchester
State: Connecticut
ZIP Code: 06040-4131
Phone: (860) 918-5953

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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