MEDICARE: WEST HAVEN PEDIATRICS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	049082	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578095634
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST HAVEN PEDIATRICS, LLC

Provider Business Mailing Address
First Line	:	367 ELM ST
Second Line	:	2ND FLOOR
City	:	WEST HAVEN
State	:	CT
Zip	:	06516-4217
Country	:	US
Telephone Number	:	203-932-3227
Fax Number	:

Provider Business Practice Location Address
First Line	:	367 ELM ST
Second Line	:	2ND FLOOR
City	:	WEST HAVEN
State	:	CT
Zip	:	06516-4217
Country	:	US
Telephone Number	:	203-932-3227
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PEDIATRICIAN
Name	:	DR. JOBEY JACOB
Credential	:
Telephone Number	:	203-932-3227

Provider Enumeration Date	:	03/29/2017
Last Update Date	:	03/29/2017

Similar Medicare Providers

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1043397557 — DR. SIMONE K. SIMON M.D.
Practice Location Address:

365 ELM ST
WEST HAVEN, CT
06516-4217

Practice Phone: 203-932-3227
Practice Fax: 203-931-2848

1841498839 — STAYWELL PEDIATRIC LLC
Practice Location Address:

365 ELM ST
WEST HAVEN, CT
06516-4217

Practice Phone: 203-932-3227
Practice Fax:

1255521019 — STAYWELL PEDIATRIC LLC
Practice Location Address:

365 ELM ST
WEST HAVEN, CT
06516-4217

Practice Phone: 203-932-3227
Practice Fax: 203-931-2847

1114167350 — JOBEY JACOB M.D.
Practice Location Address:

365 ELM ST
WEST HAVEN, CT
06516-4217

Practice Phone: 203-932-3227
Practice Fax:

1104294644 — WEST HAVEN PEDIATRICS, LLC
Practice Location Address:

367 ELM ST
WEST HAVEN, CT
06516-4217

Practice Phone: 203-932-3227
Practice Fax: 203-931-2848

Directions to “WEST HAVEN PEDIATRICS, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.