Individual
DR. JONATHAN D BECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11 OLD PARK LANE RD, NEW MILFORD, CT 06776-2507
(860) 355-1149
Mailing address
11 OLD PARK LANE RD, NEW MILFORD, CT 06776-2507
(806) 355-1149
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
042308
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008003881
—
CT
01
—
830401703
TAX ID
CT
Enumeration date
12/01/2006
Last updated
09/11/2023
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