Philip, Jisha
Philip, Jisha is an sole proprietor health care provider with primary practice located at 968 Fairfield Ave , Bridgeport CT 06605-1116. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Philip, Jisha can be contacted via phone (203) 330-6000.Contact Information
Primary practice address
968 Fairfield Ave
Bridgeport CT 06605-1116
Phone: (203) 330-6000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 48331 | Connecticut |
Profile Details
| NPI number | 1194863852 |
|---|---|
| LBN Legal business name | Philip, Jisha |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 2nd, 2007 |
| Last updated | Jan 5th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194863852 | NPPES |
| Connecticut | MEDICAID | 004236148 |
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