Jaquez, Janis A.

Jaquez, Janis A. is an individual health care provider with primary practice located at 74 Park Rd , West Hartford CT 06119-1853. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Jaquez, Janis A. can be contacted via phone (860) 218-1725.

Contact Information

Primary practice address
74 Park Rd West Hartford CT 06119-1853
Phone: (860) 218-1725
Fax: (860) 218-1727
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 001743 Connecticut

Profile Details

NPI number 1215002779
LBN Legal business name Jaquez, Janis A.
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 21st, 2006
Last updated May 23rd, 2012 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215002779 NPPES
Connecticut Other 001743 LIC NUMBER

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