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Contact Information

JEFFREY H GOTTLIEB, MD
28 CRESCENT ST
MIDDLETOWN, CT06457-3654
 Phone: 860-344-6760
 Fax: 860-358-4829
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for JEFFREY H GOTTLIEB · (Male)

NPI # 1043292980
Status Active
Credentials MD
Entity Individual
Enumeration date 11/16/2005
Last updated 06/15/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • CT License # 028008
  • CT Medicaid 11280080
Hospital affiliation(s)
  • JOHNSON MEMORIAL HOSPITAL - (Acute Care)
    201 CHESTNUT HILL RD
    STAFFORD SPRINGS, CT 06076
  • ST FRANCIS HOSPITAL & MEDICAL CENTER - (Acute Care)
    114 WOODLAND STREET
    HARTFORD, CT 06105
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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