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General NPI Number Information
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NPI Number | 1710870050
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Entity Type | Individual
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Provider Name | JERREL A CUMMINGS
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Gender | Male
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Dates
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Enumeration Date | 06/03/2025
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 109 LEGION AVE
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City | NEW HAVEN
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State | CT
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Zip | 06519-5506
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Country | US
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Telephone | 203-562-2264
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Fax |
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Provider Business Mailing Address
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Address Line | 27 ELD ST APT F
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City | NEW HAVEN
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State | CT
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Zip | 06511-3823
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Country | US
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Telephone | 203-705-9237
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 008220
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License Number State | CT
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