Healthcare Provider Details

I. General information

NPI: 1073423745
Provider Name (Legal Business Name): JAMIE PEARL CHRISTY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 SALEM TPKE STE 200
NORWICH CT
06360-6484
US

IV. Provider business mailing address

495 LAUREL HILL RD APT 12B
NORWICH CT
06360-7220
US

V. Phone/Fax

Practice location:
  • Phone: 888-754-0398
  • Fax:
Mailing address:
  • Phone: 860-938-0553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: