Individual
DENNIS PETER JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
114 WOODLAND ST, HARTFORD, CT 06105-1208
(860) 714-5484
(734) 793-2471
Mailing address
ADMINSTRATION -SUITE 4309B, 1000 ASYLUM AVENUE, HARTFORD, CT 06105
(860) 714-5484
(734) 793-2471
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
70093
CT
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/25/2019
Last updated
06/01/2022
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