Individual
DR. JEAN K JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
2117 BOSTON AVE, BRIDGEPORT, CT 06610-3030
(203) 493-4251
Mailing address
2117 BOSTON AVE, BRIDGEPORT, CT 06610-3030
(203) 493-4251
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051292532
IL
183500000X
Pharmacist
28RI02804900
NJ
183500000X
Pharmacist
Primary
PCT0009700
CT
Other
Enumeration date
09/04/2009
Last updated
12/26/2015
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