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Individual

JEROME WILLIAM TAKIFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
895 EAST MAIN STREET, TORRINGTON, CT 06790
(860) 489-1291
(860) 489-1804
Mailing address
895 EAST MAIN STREET, TORRINGTON, CT 06790
(860) 489-1291
(860) 489-1804

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21436
CT
208M00000X
Hospitalist Physician
21436
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004394904
CT
01
C01177
MEDICARE GROUP UPIN
Enumeration date
07/21/2006
Last updated
06/11/2012
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