Lageman, Jill

Lageman, Jill is an individual health care provider with primary practice located at 365 Montauk Ave , New London CT 06320-4700. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Lageman, Jill can be contacted via phone (860) 442-0711.

Contact Information

Primary practice address
365 Montauk Ave New London CT 06320-4700
Fax: (860) 271-4224
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 000208 Connecticut

Profile Details

NPI number 1609979830
LBN Legal business name Lageman, Jill
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2006
Last updated Jan 30th, 2015 - about 9 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 1609979830 NPPES
Other 06-0646704 TRICARE
MEDICAID 4014679 TRICARE
MEDICAID 4024972 TRICARE

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