Individual
AYANA M JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
53 BURDON LN, NEWINGTON, CT 06111-2715
(860) 422-3826
Mailing address
53 BURDON LN, NEWINGTON, CT 06111-2715
(860) 422-3826
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7176
CT
363A00000X
Physician Assistant
—
—
Other
Enumeration date
06/05/2025
Last updated
07/23/2025
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