Individual
JEFFREY H. GOTTLIEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 344-6760
(860) 358-4829
Mailing address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 344-6760
(860) 358-4829
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
028008
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11280080
—
CT
Enumeration date
11/16/2005
Last updated
06/15/2010
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