Individual
PETER JAMES JACOBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
56 FRANKLIN ST, WATERBURY, CT 06706-1221
(203) 709-6004
(203) 709-3700
Mailing address
56 FRANKLIN ST, 3RD FLOOR, WATERBURY, CT 06706-1221
(203) 709-8873
(203) 709-8689
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
019781
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001197814
—
CT
Enumeration date
07/14/2006
Last updated
11/12/2021
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