Individual
HARRIS C JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20 YORK ST, YNHH (CHILDREN'S) WEST PAVILION 4TH FLOOR, NEW HAVEN, CT 06510-3220
(203) 688-2318
Mailing address
PO BOX 9805, 300 GEORGE STREET 6TH FLOOR, NEW HAVEN, CT 06536-0805
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
025856
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001258565
—
CT
Enumeration date
11/29/2005
Last updated
07/21/2008
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