Individual
JANELLE N JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
73 WATERBURY RD UNIT 3, PROSPECT, CT 06712-1252
(860) 983-0708
Mailing address
9 GARVAN ST, EAST HARTFORD, CT 06108-3032
(860) 983-0708
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
24-0636
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20-0579
—
CT
05
—
92-2397046
—
CT
Enumeration date
03/10/2023
Last updated
06/12/2025
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