Healthcare Provider Details

I. General information

NPI: 1336571116
Provider Name (Legal Business Name): JASON LEE CHERTOFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2013
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 SILAS DEANE HWY STE 105
WETHERSFIELD CT
06109-4363
US

IV. Provider business mailing address

26 HITCHCOCK RD
WESTPORT CT
06880-2632
US

V. Phone/Fax

Practice location:
  • Phone: 860-547-1876
  • Fax:
Mailing address:
  • Phone: 917-232-0297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.135018
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME134216
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberU6932
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number75822
License Number StateCT
# 5
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA10976700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: