Individual
JORGE ALBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
71 HAYNES ST, MANCHESTER, CT 06040-4131
(860) 646-1222
(860) 647-6439
Mailing address
71 HAYNES ST, MANCHESTER, CT 06040-4131
(860) 646-1222
(860) 647-6439
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
043658
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001436685
—
CT
Enumeration date
11/29/2005
Last updated
01/29/2008
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