Individual
MR. JEFFREY DANIEL SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4695 MAIN ST, BRIDGEPORT, CT 06606-1802
(203) 372-4419
(203) 372-4919
Mailing address
4695 MAIN STREET, BRIDGEPORT, CT 06606
(203) 372-4419
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
030495
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001304956
—
CT
Enumeration date
09/07/2005
Last updated
10/22/2013
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