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General NPI Number Information
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NPI Number | 1588478135
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Entity Type | Organization
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Legal Business Name | KELLY JAZIRI, M.D. PSYCHIATRIC SERVICES, LLC
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 108 NEW LONDON TPKE
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City | NORWICH
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State | CT
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Zip | 06360-2645
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Country | US
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Telephone | 860-889-3052
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Fax | 860-889-0926
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Provider Business Mailing Address
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Address Line | 108 NEW LONDON TPKE
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City | NORWICH
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State | CT
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Zip | 06360-2645
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Country | US
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Telephone | 860-889-3052
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Fax | 860-889-0926
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Authorized Official
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Title or Position | OWNER/PSYCHIATRIST
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Name | DR. KELLY JAZIRI
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Credential | MD
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Telephone | 860-889-3052
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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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