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LAWRENCE M. JACOBY M.D. PC NPI 1942405246


NPI Information

NPI: 1942405246
Provider Name: LAWRENCE M. JACOBY, M.D., PC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
18 W AVON RD
AVON, CT
ZIP 06001
Phone: (860) 673-1667
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LAWRENCE M. JACOBY, M.D., PC is a specialist in Avon, CT. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. LAWRENCE M. JACOBY, M.D., PC NPI is 1942405246. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

18 W AVON RD
AVON, CT
ZIP 06001-583
Phone: (860) 673-1667
Fax: (860) 673-1544

The provider's authorized official is Jodie Jacoby .
The authorized official title is Office Manager and has the following contact phone number (860) 673-1667.

The enumeration date for this NPI number is 6/18/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist016756CONNECTICUTYes
2174400000XSpecialist022522CONNECTICUTX
3363A00000XPhysician Assistant000178CONNECTICUTX

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1010016756CT01OTHERCONNECTICUTBCBS ANTHEM CONNECTICUT
244259OTHERCONNECTICUTAETNA
3701896OTHERCONNECTICUTCONNECTICARE DR.
4290000178CT01OTHERDELAWAREBCBS ANTHEM CT -- PA
5P1595383OTHERCONNECTICUTOXFORD
618000OTHERCONNECTICUTCONNECTICARE PA
7731541OTHERCONNECTICUTPHCS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.