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General NPI Number Information
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NPI Number | 1932401205
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER JAKUBOWSKI MD LLC
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Dates
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Enumeration Date | 11/18/2010
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Last Update Date | 11/18/2010
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Provider Practice Location Address
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Address Line | 244 MAIN ST
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City | MERIDEN
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State | CT
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Zip | 06451-5149
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Country | US
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Telephone | 203-630-9722
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Fax | 203-630-9725
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Provider Business Mailing Address
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Address Line | 244 MAIN ST
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City | MERIDEN
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State | CT
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Zip | 06451-5149
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Country | US
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Telephone | 203-630-9722
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Fax | 203-630-9725
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Authorized Official
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Title or Position | OWNER
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Name | DR. KRZYSZTOF JAKUBOWSKI
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Credential | MD
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Telephone | 203-630-9722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 036481
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License Number State | CT
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