Stanford, Jennie Thomas

Stanford, Jennie Thomas is an sole proprietor health care provider with primary practice located at 69 Grove St , New Canaan CT 06840-5325. She recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Medical Specialty, Ambulatory Health Care Facilities / Clinic/Center. Ambulatory Health Care Facilities / Clinic/Center is her primary health care specialty. Stanford, Jennie Thomas can be contacted via phone (844) 359-8363.

Contact Information

Primary practice address
69 Grove St New Canaan CT 06840-5325
Phone: (844) 359-8363
Fax: (833) 929-3520
Website:
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Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Medical Specialty 261QM2500X 1992372403 New Jersey
Ambulatory Health Care Facilities / Medical Specialty 261QM2500X 1992372403 Connecticut
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X 1043889967 New York

Profile Details

NPI number 1588028153
LBN Legal business name Stanford, Jennie Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 11th, 2016
Last updated Jul 16th, 2024 - about 2 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 1588028153 NPPES
Mississippi MEDICAID 07129501

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