Healthcare Provider Details

I. General information

NPI: 1184159832
Provider Name (Legal Business Name): JAMES EDWARD BABOWICE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2017
Last Update Date: 07/20/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1290 SILAS DEANE HWY
WETHERSFIELD CT
06109-4337
US

IV. Provider business mailing address

1430 RIVER BOAT CIR APT 304
MEMPHIS TN
38103-6988
US

V. Phone/Fax

Practice location:
  • Phone: 860-972-9033
  • Fax:
Mailing address:
  • Phone: 847-970-2778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number074627
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: