Jabbour, Ihsan I
Jabbour, Ihsan I is an sole proprietor health care provider with primary practice located at 171 Grandview Ave Suite # 105, Waterbury CT 06708-2517. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Jabbour, Ihsan I can be contacted via phone (203) 755-2214.Contact Information
Primary practice address
171 Grandview Ave Suite # 105
Waterbury CT 06708-2517
Phone: (203) 755-2214
Fax: (203) 596-1133
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine | 207PE0005X | 026820 | Connecticut |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 026820 | Connecticut |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 026820 | Connecticut |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 026820 | Connecticut |
Profile Details
| NPI number | 1407899610 |
|---|---|
| LBN Legal business name | Jabbour, Ihsan I |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 14th, 2006 |
| Last updated | Jan 19th, 2017 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407899610 | NPPES |
| Connecticut | MEDICAID | 001268200 | |
| Connecticut | Other | 010026820CT03 | |
| Connecticut | Other | 135799 | |
| Connecticut | Other | P2041646 | |
| Connecticut | Other | 061212173 | |
| Connecticut | Other | 061212173 | |
| Connecticut | Other | 712173 | |
| Connecticut | Other | 061212173 0005 | |
| Connecticut | Other | 0R0697 | |
| Connecticut | Other | 0004112221 | |
| Connecticut | Other | 026820CT NO2 |
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