Elias, Jack A

Elias, Jack A is an individual health care provider with primary practice located at 789 Howard Ave Fitkin Building - 2Nd Floor, New Haven CT 06519-1304. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Elias, Jack A can be contacted via phone (203) 785-4198.

Contact Information

Primary practice address
789 Howard Ave Fitkin Building - 2Nd Floor New Haven CT 06519-1304
Fax: (203) 785-3826
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 030931 Connecticut
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 030931 Connecticut

Profile Details

NPI number 1053394114
LBN Legal business name Elias, Jack A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 22nd, 2005
Last updated Jul 1st, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1053394114 NPPES
Connecticut MEDICAID 001309310

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