Jewish Home for Aged

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

32-C Issued in CT

Legal business name

JEWISH HOME FOR AGED

Practice address

169 Davenport Ave
New Haven, CT 06519

Phone

(203) 789-1650

Fax

(203) 787-0071

NPI assigned

Oct 3, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Suzanne Marie Bousquet

Title

Cfo

Phone

(703) 789-1650

Specialties & licenses 1

Addresses

Other identifiers 3

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218672000000",
    "number": "1154318335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 DAVENPORT AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06519",
            "telephone_number": "203-789-1650",
            "fax_number": "203-787-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 DAVENPORT AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06519",
            "telephone_number": "203-789-1650",
            "fax_number": "203-787-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEWISH HOME FOR AGED",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2008-08-14",
        "status": "A",
        "authorized_official_last_name": "BOUSQUET",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "703-789-1650"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "32-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000323",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE HMO",
            "identifier": "71-01006",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS OF CT",
            "identifier": "706",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika Jessen, M. D.
• Jessica R Fay LCSW LLC
• Kimberly Jewers-Dailley, M.A., RDT
• Jewish Family Service of New Haven Inc
• Jewish Family Service of New Haven Inc.
• Jha Health Care, Inc.
• CHI-Fong Jha, PA-C
• Feng Jiang, MD
• Nona Ming Jiang, MD
• Ruoyi Jiang

• Skilled Nursing Facility in New Haven, CT
• Providers in New Haven, CT by specialty
• Skilled Nursing Facility in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.