Individual
JEREMY TAKAHASHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
367 CEDAR ST # 421, NEW HAVEN, CT 06510-3222
(925) 301-5005
Mailing address
367 CEDAR ST # 421, NEW HAVEN, CT 06510-3222
(925) 301-5005
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
N/A
CT
Other
Enumeration date
06/22/2011
Last updated
01/03/2022
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