Organization
JILL DUBOFF-JACOMINI APRN, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL DUBOFF-JACOMINI APRN (OWNER)
(860) 712-8863
Entity
Organization
Contact information
Practice address
816 BROAD ST STE 23, MERIDEN, CT 06450-4350
(860) 712-8863
Mailing address
75 POND SIDE DR, WETHERSFIELD, CT 06109-4153
(860) 712-8863
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
800
APRN LICENSE
CT
Enumeration date
11/02/2022
Last updated
11/02/2022
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