| Jcallenmd, Llc | |
|
765 E Main St Branford CT 06405-2922 | |
| (860) 378-7841 | |
| Not Available |
| Full Name | Jcallenmd, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 765 E Main St, Branford, Connecticut |
| Authorized Official Name and Position | Jonathan Craig Allen (CEO/PRESIDENT) |
| Authorized Official Contact | 8603787841 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jcallenmd, Llc 106 Concord Drive Madison CT 06443-2560 Ph: (860) 378-7841 | Jcallenmd, Llc 765 E Main St Branford CT 06405-2922 Ph: (860) 378-7841 |
| NPI Number | 1063956316 |
|---|---|
| Provider Enumeration Date | 12/06/2016 |
| Last Update Date | 12/06/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063956316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 041054 (Connecticut) | Primary |
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