Individual
JEROME JAMES JOSEPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
130 HARTFORD RD, MANCHESTER, CT 06040-5921
(860) 533-4679
Mailing address
71 HAYNES ST, MANCHESTER, CT 06040-4131
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1.078232-DO
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2021
Last updated
07/15/2024
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