Individual
THEODORE JELLINEK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
449 ROUTE 130, SANDWICH, MA 02563
(508) 888-9241
(508) 888-9243
Mailing address
PO BOX 905, FALMOUTH, MA 02541
(508) 548-8989
(508) 548-5789
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
29712
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100754
MAGELLAN
—
01
—
703893
TUFTS
—
Enumeration date
04/20/2006
Last updated
07/08/2007
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