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Individual

HENRY ELI JACOBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 NORTHWESTERN DR, SUITE 202, BLOOMFIELD, CT 06002-3400
(860) 233-8589
(860) 236-9636
Mailing address
1 NORTHWESTERN DR, SUITE 202, BLOOMFIELD, CT 06002-3400
(860) 233-8589
(860) 236-9636

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
017368
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001173681
CT
01
0029111
AETNA US HEALTHCARE
CT
01
010017368CT01
BLUE SHIELD
CT
01
01017368
CIGNA
CT
01
030810
CONNECTICARE
CT
01
052270
HEALTH NET
CT
01
HAP255
OXFORD
CT
Enumeration date
08/05/2006
Last updated
12/31/2020
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