Jorge Dabdoub MD Internal Medicine LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

033578 Issued in CT

Legal business name

JORGE DABDOUB MD INTERNAL MEDICINE LLC

Practice address

12 Case St
Suite 104
Norwich, CT 06360-2222

Phone

(860) 889-4476

Fax

(860) 889-6452

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jorge A Dabdoub, M.D.

Title

Owner

Phone

(860) 889-4476

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363737600000",
    "number": "1609985654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 CASE ST",
            "address_2": "SUITE 104",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602222",
            "telephone_number": "860-889-4476",
            "fax_number": "860-889-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 CASE ST",
            "address_2": "SUITE 104",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602222",
            "telephone_number": "860-889-4476",
            "fax_number": "860-889-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORGE DABDOUB MD INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-03-20",
        "status": "A",
        "authorized_official_last_name": "DABDOUB",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-889-4476",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CT",
            "license": "033578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1335787",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen M Joly, APRN
• Rhonda Elaine Jones-Labonte, M.S.
• Cheryl C Jones, LMT
• Quansheem T Jones
• Russell Jones
• Janiah T Josehph-Poinson
• Joseph Labrecque LPC LLC
• Michelle Joseph
• Martha Jove-D'Amato, M.A., CCC-A
• Amanda Joyce, PA-C

• Primary Care Clinic/Center in Norwich, CT
• Providers in Norwich, CT by specialty
• Primary Care Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2013; 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.