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General NPI Number Information
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NPI Number | 1245724087
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Entity Type | Organization
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Legal Business Name | JMSTHERAPEUTICS
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Dates
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Enumeration Date | 06/15/2018
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Last Update Date | 06/15/2018
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Provider Practice Location Address
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Address Line | 71 BRADLEY RD UNIT 6
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City | MADISON
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State | CT
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Zip | 06443-2662
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Country | US
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Telephone | 203-421-6242
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Fax | 203-421-6808
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Provider Business Mailing Address
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Address Line | 71 BRADLEY RD UNIT 6
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City | MADISON
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State | CT
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Zip | 06443-2662
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Country | US
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Telephone | 203-421-6242
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Fax | 203-421-6808
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Authorized Official
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Title or Position | MEMBER
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Name | MR. JAY SEIGEL
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Credential |
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Telephone | 203-421-6242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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