Healthcare Provider Details

I. General information

NPI: 1518189612
Provider Name (Legal Business Name): JIGISHA PATEL MOROSKY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 04/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 CRANBROOK BLVD
ENFIELD CT
06082-3889
US

IV. Provider business mailing address

2110 SILAS DEANE HWY
ROCKY HILL CT
06067-2313
US

V. Phone/Fax

Practice location:
  • Phone: 860-253-5330
  • Fax: 860-253-5331
Mailing address:
  • Phone: 860-258-3470
  • Fax: 860-571-6800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number045357
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number045357
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number045357
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: