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General NPI Number Information
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NPI Number | 1982685889
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Entity Type | Individual
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Provider Name | CARINE JEAN MD
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Gender | Female
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 203 BROAD ST UNIT C-4
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City | MILFORD
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State | CT
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Zip | 06460-4750
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Country | US
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Telephone | 203-880-9003
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Fax | 203-268-8075
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Provider Business Mailing Address
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Address Line | 1635 CENTRAL AVE
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City | BRIDGEPORT
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State | CT
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Zip | 06610-2717
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Country | US
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Telephone | 203-551-7522
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Fax | 203-551-7037
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 033954
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License Number State | CT
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