National Provider Identifier Database

IHSAN I JABBOUR, MD – NPI #1407899610
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Contact Information

IHSAN I JABBOUR, MD
171 GRANDVIEW AVE
SUITE # 105
WATERBURY, CT  06708-2517
Phone: 203-755-2214
Fax: 203-596-1133
Website:
Specialty Taxonomy Code
* General Practice 208D00000X
Family Medicine 207Q00000X
Surgery 208600000X
Undersea and Hyperbaric Medicine 207PE0005X

* Indicates primary specialty

NPI Profile & details for IHSAN I JABBOUR

NPI Number 1407899610
Credentials MD
Entity Individual
Enumeration date 06/14/2006
Last updated 01/19/2017 - About 9 years ago
Sole proprietor1 Yes
Identifiers
  • CT License #: 026820
  • CT Medicaid: 001268200
  • CT Other: 061212173 AEBH
  • CT Other: 0004112221 AETNA
  • CT Other: 010026820CT03 BC/BS
  • CT Other: 026820CT NO2 CONNECTICARE
  • CT Other: 712173 CONNECTICARE
  • CT Other: P2041646 OXFORD
  • CT Other: 0R0697 PHS
  • FL Other: 135799 WELLCARE
  • TN Other: 061212173 0005 CIGNA
  • UT Other: 061212173 UNITED HEALTH CARE
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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