Individual
DR. IHSAN I JABBOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
171 GRANDVIEW AVE, SUITE # 105, WATERBURY, CT 06708-2517
(203) 755-2214
(203) 596-1133
Mailing address
171 GRANDVIEW AVE, SUITE # 105, WATERBURY, CT 06708-2517
(203) 755-2214
(203) 596-1133
Taxonomy
Speciality
Code
Description
License number
State
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
026820
CT
207Q00000X
Family Medicine Physician
026820
CT
208600000X
Surgery Physician
026820
CT
208D00000X
General Practice Physician
Primary
026820
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004112221
AETNA
CT
05
—
001268200
—
CT
01
—
010026820CT03
BC/BS
CT
01
—
026820CT NO2
CONNECTICARE
CT
01
—
061212173
AEBH
CT
01
—
061212173
UNITED HEALTH CARE
UT
01
—
061212173 0005
CIGNA
TN
01
—
0R0697
PHS
CT
01
—
135799
WELLCARE
FL
01
—
712173
CONNECTICARE
CT
01
—
P2041646
OXFORD
CT
Enumeration date
06/14/2006
Last updated
01/19/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us