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General NPI Number Information
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NPI Number | 1649210501
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Entity Type | Organization
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Legal Business Name | JEFFREY P THOMPSEN, MD, LLC
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9 PALOMBA DR SUITE 11
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City | ENFIELD
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State | CT
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Zip | 06082-3823
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Country | US
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Telephone | 860-687-1229
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Fax | 860-687-1229
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Provider Business Mailing Address
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Address Line | 9 PALOMBA DR SUITE 11
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City | ENFIELD
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State | CT
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Zip | 06082-3823
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Country | US
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Telephone | 860-687-1229
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Fax | 860-687-1229
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY P THOMPSEN
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Credential | MD
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Telephone | 860-687-1229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 041802
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License Number State | CT
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