Healthcare Provider Details

I. General information

NPI: 1801118252
Provider Name (Legal Business Name): JASMINA KRSTIC M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JASMINA FILIPOVIC M.D.

II. Dates (important events)

Enumeration Date: 02/25/2010
Last Update Date: 11/23/2022
Certification Date: 11/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL PLZ
STAMFORD CT
06902-3602
US

IV. Provider business mailing address

81 MAPLE AVE S
WESTPORT CT
06880-6339
US

V. Phone/Fax

Practice location:
  • Phone: 203-276-7298
  • Fax: 203-276-4842
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number61123
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: