Jaquez, Corey
Jaquez, Corey is an individual health care provider with primary practice located at 17 Church Hill Rd , Trumbull CT 06611-3116. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jaquez, Corey can be contacted via phone (203) 696-3550.Contact Information
Primary practice address
17 Church Hill Rd
Trumbull CT 06611-3116
Phone: (203) 696-3550
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 048223 | Connecticut |
Profile Details
| NPI number | 1205073962 |
|---|---|
| LBN Legal business name | Jaquez, Corey |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 15th, 2009 |
| Last updated | Oct 10th, 2017 - about 8 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 | 1205073962 | NPPES |
| Connecticut | MEDICAID | 008017106 |
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